دورية أكاديمية
Acute kidney injury after out-of-hospital cardiac arrest.
| العنوان: | Acute kidney injury after out-of-hospital cardiac arrest. |
|---|---|
| المؤلفون: | Jeppesen KK; Department of Cardiology, Odense University Hospital, J. B. Winsloews Vej 4, 5000, Odense C, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Rasmussen SB; Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Kjaergaard J; Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Schmidt H; Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Mølstrøm S; Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark., Beske RP; Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark., Grand J; Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark., Ravn HB; Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Winther-Jensen M; Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark., Meyer MAS; Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark., Hassager C; Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Møller JE; Department of Cardiology, Odense University Hospital, J. B. Winsloews Vej 4, 5000, Odense C, Denmark. jacob.moeller1@rsyd.dk.; Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. jacob.moeller1@rsyd.dk.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark. jacob.moeller1@rsyd.dk. |
| المصدر: | Critical care (London, England) [Crit Care] 2024 May 18; Vol. 28 (1), pp. 169. Date of Electronic Publication: 2024 May 18. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 9801902 Publication Model: Electronic Cited Medium: Internet ISSN: 1466-609X (Electronic) Linking ISSN: 13648535 NLM ISO Abbreviation: Crit Care Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: London, UK : BioMed Central Ltd Original Publication: London : Current Science Ltd, c1997- |
| مواضيع طبية MeSH: | Acute Kidney Injury*/therapy , Acute Kidney Injury*/etiology , Acute Kidney Injury*/physiopathology , Out-of-Hospital Cardiac Arrest*/therapy , Out-of-Hospital Cardiac Arrest*/mortality , Out-of-Hospital Cardiac Arrest*/complications, Aged ; Female ; Humans ; Male ; Middle Aged ; Proportional Hazards Models |
| مستخلص: | Background: Acute kidney injury (AKI) is a significant risk factor associated with reduced survival following out-of-hospital cardiac arrest (OHCA). Whether the severity of AKI simply serves as a surrogate measure of worse peri-arrest conditions, or represents an additional risk to long-term survival remains unclear. Methods: This is a sub-study derived from a randomized trial in which 789 comatose adult OHCA patients with presumed cardiac cause and sustained return of spontaneous circulation (ROSC) were enrolled. Patients without prior dialysis dependent kidney disease and surviving at least 48 h were included (N = 759). AKI was defined by the kidney disease: improving global outcome (KDIGO) classification, and patients were divided into groups based on the development of AKI and the need for continuous kidney replacement therapy (CKRT), thus establishing three groups of patients-No AKI, AKI no CKRT, and AKI CKRT. Primary outcome was overall survival within 365 days after OHCA according to AKI group. Adjusted Cox proportional hazard models were used to assess overall survival within 365 days according to the three groups. Results: In the whole population, median age was 64 (54-73) years, 80% male, 90% of patients presented with shockable rhythm, and time to ROSC was median 18 (12-26) min. A total of 254 (33.5%) patients developed AKI according to the KDIGO definition, with 77 requiring CKRT and 177 without need for CKRT. AKI CKRT patients had longer time-to-ROSC and worse metabolic derangement at hospital admission. Overall survival within 365 days from OHCA decreased with the severity of kidney injury. Adjusted Cox regression analysis found that AKI, both with and without CKRT, was significantly associated with reduced overall survival up until 365 days, with comparable hazard ratios relative to no AKI (HR 1.75, 95% CI 1.13-2.70 vs. HR 1.76, 95% CI 1.30-2.39). Conclusions: In comatose patients who had been resuscitated after OHCA, patients developing AKI, with or without initiation of CKRT, had a worse 1-year overall survival compared to non-AKI patients. This association remains statistically significant after adjusting for other peri-arrest risk factors. Trial Registration: The BOX trial is registered at ClinicalTrials.gov: NCT03141099. (© 2024. The Author(s).) |
| References: | Minerva Anestesiol. 2016 Sep;82(9):989-99. (PMID: 26957119) Acta Anaesthesiol Scand. 2016 Sep;60(8):1170-81. (PMID: 27306254) Lancet. 2020 May 9;395(10235):1506-1515. (PMID: 32334654) Ann Intensive Care. 2022 Jul 18;12(1):69. (PMID: 35843964) Perioper Med (Lond). 2021 Jun 29;10(1):24. (PMID: 34183067) N Engl J Med. 2022 Oct 20;387(16):1467-1476. (PMID: 36027567) Circulation. 2023 Dec 5;148(23):1860-1869. (PMID: 37791480) Can J Cardiol. 2019 Sep;35(9):1158-1169. (PMID: 31472814) Resuscitation. 2020 Oct;155:55-64. (PMID: 32755665) Healthcare (Basel). 2019 Jan 14;7(1):. (PMID: 30646533) Curr Opin Crit Care. 2004 Jun;10(3):208-12. (PMID: 15166838) Resuscitation. 2020 Jun;151:10-17. (PMID: 32087257) Resuscitation. 2008 Dec;79(3):350-79. (PMID: 18963350) Scand Cardiovasc J. 2018 Oct;52(5):238-243. (PMID: 30182752) N Engl J Med. 2021 Nov 4;385(19):1737-1749. (PMID: 34554658) J Crit Care. 2019 Apr;50:234-241. (PMID: 30586655) J Crit Care. 2019 Dec;54:65-73. (PMID: 31362189) Resuscitation. 2019 Aug;141:144-150. (PMID: 31271728) N Engl J Med. 2023 Mar 9;388(10):888-897. (PMID: 36342119) Hosp Pract (1995). 2021 Oct;49(4):280-291. (PMID: 33993820) J Crit Care. 2019 Dec;54:197-204. (PMID: 31521016) Resuscitation. 2020 Nov;156:A80-A119. (PMID: 33099419) J Intensive Care Med. 2021 May;36(5):550-556. (PMID: 32242492) N Engl J Med. 2022 Oct 20;387(16):1456-1466. (PMID: 36027564) Kidney Int Rep. 2019 Feb 13;4(5):674-678. (PMID: 31080922) Crit Care. 2019 May 8;23(1):163. (PMID: 31068215) Nat Rev Dis Primers. 2021 Jul 15;7(1):52. (PMID: 34267223) Circ J. 2018 Dec 25;83(1):139-146. (PMID: 30333435) J Crit Care. 2018 Oct;47:254-259. (PMID: 30071447) Crit Care. 2019 Jul 15;23(1):256. (PMID: 31307504) Cochrane Database Syst Rev. 2022 Nov 23;11:CD010612. (PMID: 36416787) N Engl J Med. 2020 Jul 16;383(3):240-251. (PMID: 32668114) Circulation. 2021 Mar 16;143(11):1157-1172. (PMID: 33720773) |
| معلومات مُعتمدة: | R186-2015-2132 The Lundbeck Foundation |
| فهرسة مساهمة: | Keywords: Acute kidney injury; Cardiopulmonary resuscitation; Continuous kidney replacement therapy; Post-cardiac arrest |
| سلسلة جزيئية: | ClinicalTrials.gov NCT03141099 |
| تواريخ الأحداث: | Date Created: 20240518 Date Completed: 20240518 Latest Revision: 20240531 |
| رمز التحديث: | 20240601 |
| مُعرف محوري في PubMed: | PMC11102609 |
| DOI: | 10.1186/s13054-024-04936-w |
| PMID: | 38762578 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1466-609X |
|---|---|
| DOI: | 10.1186/s13054-024-04936-w |