{"title":"急性肾损伤的发展是感染性心内膜炎死亡率的独立预测因素","authors":"","doi":"10.1016/j.nefro.2023.03.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Infective endocarditis presents a 25% mortality. Acute kidney injury (AKI) develops in up to 70% of the cases. The aim of this study is to evaluate the predictive value of AKI in mortality due to endocarditis and to assess its associated factors.</p></div><div><h3>Methods</h3><p>Unicentric and retrospective study including all patients with in-hospital diagnosis of endocarditis between 2015 and 2021. Epidemiological data and comorbidities were collected at baseline. During admission, renal function parameters, infection-related variables and mortality were collected. Using adjusted multivariate models, LRA predictive value was determined.</p></div><div><h3>Results</h3><p>One hundred and thirty-four patients (63% males, age 72±15 years) were included. Of them 94 (70%) developed AKI (50% AKIN-1, 29% AKIN-2 and 21% AKIN-3). Factors associated to AKI were age (p=0.03), hypertension (p=0.005), previous chronic kidney disease (p=0.001), heart failure (p=0.006), peripheral vascular disease (p=0.022) and glomerular filtration rate (GFR) at baseline (p<0.001). GFR at baseline was the only factor independently associated to AKI (OR 0.94, p=0.001).</p><p>In-hospital deaths were registered in 46 (34%) patients. Of them, 45 (98%) patients had developed AKI. AKI was independently associated to mortality through diverse multivariate models. GFR loss (OR 1.054, p<0.001) and GFR at baseline (0.963, p=0.012) also predicted mortality during admission.</p></div><div><h3>Conclusions</h3><p>AKI development and its severity (GFR loss and AKIN severity) impacts in in-hospital mortality due to infective endocarditis.</p></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0211699523000395/pdfft?md5=cc1948f5945cd53ab520759f2bf0635a&pid=1-s2.0-S0211699523000395-main.pdf","citationCount":"0","resultStr":"{\"title\":\"El desarrollo de una lesión renal aguda es un predictor independiente de mortalidad en las endocarditis infecciosas\",\"authors\":\"\",\"doi\":\"10.1016/j.nefro.2023.03.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Infective endocarditis presents a 25% mortality. Acute kidney injury (AKI) develops in up to 70% of the cases. The aim of this study is to evaluate the predictive value of AKI in mortality due to endocarditis and to assess its associated factors.</p></div><div><h3>Methods</h3><p>Unicentric and retrospective study including all patients with in-hospital diagnosis of endocarditis between 2015 and 2021. Epidemiological data and comorbidities were collected at baseline. During admission, renal function parameters, infection-related variables and mortality were collected. Using adjusted multivariate models, LRA predictive value was determined.</p></div><div><h3>Results</h3><p>One hundred and thirty-four patients (63% males, age 72±15 years) were included. Of them 94 (70%) developed AKI (50% AKIN-1, 29% AKIN-2 and 21% AKIN-3). Factors associated to AKI were age (p=0.03), hypertension (p=0.005), previous chronic kidney disease (p=0.001), heart failure (p=0.006), peripheral vascular disease (p=0.022) and glomerular filtration rate (GFR) at baseline (p<0.001). GFR at baseline was the only factor independently associated to AKI (OR 0.94, p=0.001).</p><p>In-hospital deaths were registered in 46 (34%) patients. Of them, 45 (98%) patients had developed AKI. AKI was independently associated to mortality through diverse multivariate models. GFR loss (OR 1.054, p<0.001) and GFR at baseline (0.963, p=0.012) also predicted mortality during admission.</p></div><div><h3>Conclusions</h3><p>AKI development and its severity (GFR loss and AKIN severity) impacts in in-hospital mortality due to infective endocarditis.</p></div>\",\"PeriodicalId\":18997,\"journal\":{\"name\":\"Nefrologia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0211699523000395/pdfft?md5=cc1948f5945cd53ab520759f2bf0635a&pid=1-s2.0-S0211699523000395-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nefrologia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0211699523000395\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nefrologia","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0211699523000395","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
导言感染性心内膜炎的死亡率为 25%。70%的病例会出现急性肾损伤(AKI)。本研究旨在评估急性肾损伤在心内膜炎死亡率中的预测价值,并评估其相关因素。基线收集流行病学数据和合并症。入院期间,收集肾功能参数、感染相关变量和死亡率。结果 共纳入 134 名患者(63% 为男性,年龄为 72±15 岁)。其中94人(70%)发生了AKI(50%为AKIN-1,29%为AKIN-2,21%为AKIN-3)。与 AKI 相关的因素有年龄(p=0.03)、高血压(p=0.005)、既往慢性肾病(p=0.001)、心力衰竭(p=0.006)、外周血管疾病(p=0.022)和基线肾小球滤过率(GFR)(p<0.001)。基线时的肾小球滤过率是唯一与 AKI 独立相关的因素(OR 0.94,p=0.001)。有 46 名(34%)患者在院内死亡,其中 45 名(98%)患者出现了 AKI。通过不同的多变量模型,AKI 与死亡率呈独立相关性。结论AKI的发生及其严重程度(GFR损失和AKIN严重程度)会影响感染性心内膜炎的院内死亡率。
El desarrollo de una lesión renal aguda es un predictor independiente de mortalidad en las endocarditis infecciosas
Introduction
Infective endocarditis presents a 25% mortality. Acute kidney injury (AKI) develops in up to 70% of the cases. The aim of this study is to evaluate the predictive value of AKI in mortality due to endocarditis and to assess its associated factors.
Methods
Unicentric and retrospective study including all patients with in-hospital diagnosis of endocarditis between 2015 and 2021. Epidemiological data and comorbidities were collected at baseline. During admission, renal function parameters, infection-related variables and mortality were collected. Using adjusted multivariate models, LRA predictive value was determined.
Results
One hundred and thirty-four patients (63% males, age 72±15 years) were included. Of them 94 (70%) developed AKI (50% AKIN-1, 29% AKIN-2 and 21% AKIN-3). Factors associated to AKI were age (p=0.03), hypertension (p=0.005), previous chronic kidney disease (p=0.001), heart failure (p=0.006), peripheral vascular disease (p=0.022) and glomerular filtration rate (GFR) at baseline (p<0.001). GFR at baseline was the only factor independently associated to AKI (OR 0.94, p=0.001).
In-hospital deaths were registered in 46 (34%) patients. Of them, 45 (98%) patients had developed AKI. AKI was independently associated to mortality through diverse multivariate models. GFR loss (OR 1.054, p<0.001) and GFR at baseline (0.963, p=0.012) also predicted mortality during admission.
Conclusions
AKI development and its severity (GFR loss and AKIN severity) impacts in in-hospital mortality due to infective endocarditis.
期刊介绍:
Nefrología is the official publication of the Spanish Society of Nephrology. The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants. It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages.