Tachycardia and Acute Kidney Injury among Critically Ill Patients with Sepsis: A Prospective Observational Study.

IF 2.2 3区医学 Q3 HEMATOLOGY Blood Purification Pub Date : 2024-01-01 Epub Date: 2024-06-13 DOI:10.1159/000539808

Naoki Hayase, Miyuki Yamamoto, Toshifumi Asada, Rei Isshiki, Kent Doi

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Abstract

Introduction: Tachycardia caused by sympathetic overactivity impairs myocardial function and raises septic patients' mortality. This study examined whether tachycardia is associated with acute kidney injury (AKI) period-prevalence among critically ill patients with and without sepsis.

Methods: In 328 patients (119 sepsis and 209 non-sepsis) admitted to our intensive care unit (ICU), we assessed heart rate at ICU admission, plasma neutrophil gelatinase-associated lipocalin (NGAL) and N-terminal pro-B-type natriuretic peptide, and urinary L-type fatty acid-binding protein and N-acetyl-β-d-glucosaminidase (NAG) at 0 and 48 h after admission. Tachycardia was defined as a heart rate above 100 beats/min.

Results: Tachycardia was independently correlated with AKI prevalence during the first week after ICU admission in the septic patients, but not in the non-septic patients. A dose-dependent increase in AKI period-prevalence was observed across ascending heart rate ranges. Furthermore, we discovered a dose-dependent increase in renal biomarker-positive patients regarding plasma NGAL and urinary NAG over increasing heart rate ranges 48 h after admission.

Conclusion: The findings revealed an independent relationship between tachycardia and AKI prevalence during the first week of ICU in septic patients. Heart rate was found to have a dose-dependent effect on AKI prevalence and renal insult monitored by biomarkers.

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脓毒症重症患者心动过速与急性肾损伤：一项前瞻性观察研究。

简介交感神经过度活跃导致的心动过速会损害心肌功能，并提高脓毒症患者的死亡率。本研究探讨了心动过速是否与脓毒症和非脓毒症重症患者急性肾损伤（AKI）期的发生率有关：在重症监护病房（ICU）收治的 328 名患者（119 名败血症患者和 209 名非败血症患者）中，我们评估了他们入院时的心率、血浆中性粒细胞明胶酶相关脂质钙蛋白（NGAL）和 N 端前 B 型钠尿肽，以及入院后 0 小时和 48 小时尿液中的 L 型脂肪酸结合蛋白和 N-乙酰基-β-D-氨基葡萄糖苷酶（NAG）。心动过速的定义是心率超过 100 次/分：结果：在脓毒症患者中，心动过速与入ICU后第一周的AKI发生率独立相关，而在非脓毒症患者中则不相关。在不同的心率范围内，观察到 AKI 发生率呈剂量依赖性增加。此外，我们还发现入院 48 小时后，随着心率范围的增加，肾脏生物标志物阳性患者的血浆 NGAL 和尿液 NAG 也呈剂量依赖性增加：研究结果表明，在脓毒症患者入住重症监护室的第一周，心动过速与AKI发生率之间存在独立关系。通过生物标记物监测发现，心率对 AKI 发生率和肾脏损伤具有剂量依赖性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.