Association between normal saline infusion volume in the emergency department and acute kidney injury in heat stroke patients: a multicenter retrospective study.

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-01-04 DOI:10.1080/0886022X.2023.2294151
Lan Chen, Junlu Zhao, Liyun Lu, Zhumei Gong, Shuying Xu, Xiaoling Yang, Yuping Zhang, Xiuqin Feng
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Abstract

Background: Previous studies have shown that intravenous normal saline (NS) may be associated with the incidence of acute kidney injury (AKI). This study aimed to evaluate the association between the volume of NS infusion and AKI in heat stroke (HS) patients.

Methods: This multicenter retrospective cohort study included 138 patients with HS. The primary outcome was the incidence of AKI. Secondary outcomes included the need for continuous renal replacement therapy (CRRT), admission to the intensive care unit (ICU), length of stay in the ICU and hospital, and in-hospital mortality. Multivariate regression models, random forest imputation, and genetic and propensity score matching were used to explore the relationship between NS infusion and outcomes.

Results: The mean volume of NS infusion in the emergency department (ED) was 3.02 ± 1.45 L. During hospitalization, 33 patients (23.91%) suffered from AKI. In the multivariate model, as a continuous variable (per 1 L), the volume of NS infusion was associated with the incidence of AKI (OR, 2.51; 95% CI, 1.43-4.40; p = .001), admission to the ICU (OR, 3.46; 95% CI 1.58-7.54; p = .002), and length of stay in the ICU (β, 1.00 days; 95% CI, 0.44-1.56; p < .001) and hospital (β, 1.41 days; 95% CI, 0.37-2.45; p = .008). These relationships also existed in the forest imputation cohort and matching cohort. There were no differences in the use of CRRT or in-hospital mortality.

Conclusions: The volume of NS infusion was associated with a significant increase in the incidence of AKI, admission to the ICU, and length of stay in the ICU and hospital among patients with HS.

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急诊科正常生理盐水输注量与中暑患者急性肾损伤之间的关系:一项多中心回顾性研究。
背景:以往的研究表明,静脉注射生理盐水(NS)可能与急性肾损伤(AKI)的发生率有关。本研究旨在评估中暑(HS)患者输注正常生理盐水的量与急性肾损伤(AKI)之间的关系:这项多中心回顾性队列研究纳入了 138 名中暑患者。主要结果是 AKI 的发生率。次要结果包括持续肾脏替代疗法(CRRT)需求、入住重症监护室(ICU)、重症监护室和住院时间以及院内死亡率。该研究采用多变量回归模型、随机森林归因、基因和倾向评分匹配等方法来探讨NS输注与结果之间的关系:急诊科(ED)输注 NS 的平均量为 3.02 ± 1.45 升。住院期间,33 名患者(23.91%)出现了 AKI。在多变量模型中,作为连续变量(每 1 升),NS 输注量与 AKI 的发生率相关(OR,2.51;95% CI,1.43-4.40;P = .001)、入住 ICU(OR,3.46;95% CI,1.58-7.54;p = .002)和在 ICU 的住院时间(β,1.00 天;95% CI,0.44-1.56;p β,1.41 天;95% CI,0.37-2.45;p = .008)相关。森林估算队列和匹配队列中也存在这些关系。CRRT的使用和院内死亡率没有差异:结论:NS输注量与HS患者AKI发生率、ICU入院率、ICU和住院时间的显著增加有关。
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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
期刊最新文献
The use of urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin for diagnosis of hepato-renal syndrome in advanced cirrhotic patients. Identification of common and specific fibrosis-related genes in three common chronic kidney diseases. A Mendelian randomization study: physical activities and chronic kidney disease. Association between normal saline infusion volume in the emergency department and acute kidney injury in heat stroke patients: a multicenter retrospective study. Association of frequent intradialytic hypotension with the clinical outcomes of patients on hemodialysis: a prospective cohort study.
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