Outcomes of patients with infective endocarditis-associated acute kidney injury: a retrospective cohort study.

IF 3.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Clinical Kidney Journal Pub Date : 2024-11-29 eCollection Date: 2025-01-01 DOI:10.1093/ckj/sfae382
SanXi Ai, Xiang Feng, Kai Sun, Gang Chen, XinPei Liu, Qi Miao, Yan Qin, XueMei Li
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Abstract

Background: The outcomes of patients with infective endocarditis (IE)-associated acute kidney injury (AKI) are poorly understood.

Methods: This retrospective cohort study was conducted in a tertiary hospital in China to analyze the short- and long-term outcomes among patients with IE-associated AKI. The risk factors for 90-day mortality, long-term outcomes and kidney non-recovery were analyzed via multivariable logistic regression, the Cox regression, and the Fine-Gray competing risk model, respectively.

Results: Among 294 patients with IE-associated AKI, 14.3% died within 90 days, and the risk factors for 90-day mortality were similar to those identified in the general IE population. Among the 230 AKI survivors in whom 90-day kidney recovery could be assessed, 17.4% did not recover kidney function at 90 days. Kidney non-recovery at 90 days was associated with an increased risk of the long-term composite outcome of mortality, end-stage renal disease or sustained doubling of serum creatinine [hazard ratio (HR) 3.00, 95% confidence interval (CI) 1.19-7.59]. Five variables were related to kidney non-recovery: low baseline estimated glomerular filtration rate (eGFR) (HR 2.52, 95% CI 1.73-3.65), stage of AKI (HR 3.03, 95% CI 2.07-4.42 for stage 3), shock (HR 5.56, 95% CI 3.02-10.22), glomerulonephritis-related AKI (HR 3.04, 95% CI 1.93-4.77) and drug-related AKI (HR 2.77, 95% CI 1.86-4.13).

Conclusion: Patients with IE-associated AKI had a high 90-day mortality, and a substantial proportion of survivors did not recover kidney function at 90 days. Kidney non-recovery at 90 days was associated with adverse long-term outcomes. Low baseline eGFR, severe AKI, shock, drug-related AKI and glomerulonephritis-related AKI were risk factors for kidney non-recovery.

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感染性心内膜炎相关急性肾损伤患者的预后:一项回顾性队列研究
背景:感染性心内膜炎(IE)相关急性肾损伤(AKI)患者的预后尚不清楚。方法:本回顾性队列研究在中国一家三级医院进行,分析ie相关性AKI患者的短期和长期结局。分别通过多变量logistic回归、Cox回归和Fine-Gray竞争风险模型分析90天死亡率、长期预后和肾脏未恢复的危险因素。结果:294例IE相关AKI患者中,14.3%在90天内死亡,90天死亡率的危险因素与一般IE人群相似。在230例可评估90天肾脏恢复的AKI幸存者中,17.4%在90天未恢复肾功能。90天肾脏未恢复与死亡率、终末期肾脏疾病或血清肌酐持续翻倍的长期综合结局风险增加相关[危险比(HR) 3.00, 95%可信区间(CI) 1.19-7.59]。5个变量与肾脏未恢复相关:低基线估计肾小球滤过率(eGFR) (HR 2.52, 95% CI 1.73-3.65)、AKI分期(HR 3.03, 95% CI 2.07-4.42)、休克(HR 5.56, 95% CI 3.02-10.22)、肾小球肾炎相关AKI (HR 3.04, 95% CI 1.93-4.77)和药物相关AKI (HR 2.77, 95% CI 1.86-4.13)。结论:ie相关性AKI患者的90天死亡率很高,相当大比例的幸存者在90天内没有恢复肾功能。90天肾脏未恢复与不良的长期预后相关。低基线eGFR、严重AKI、休克、药物相关性AKI和肾小球肾炎相关性AKI是肾脏无法恢复的危险因素。
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来源期刊
Clinical Kidney Journal
Clinical Kidney Journal Medicine-Transplantation
CiteScore
6.70
自引率
10.90%
发文量
242
审稿时长
8 weeks
期刊介绍: About the Journal Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.
期刊最新文献
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