{"title":"肝硬化患者血清镁浓度与急性肾损伤发病风险之间的关系：基于 MIMIC-IV 数据库的回顾性队列研究。","authors":"Bingwen Lin, Wenbiao Xiao, Peng Huang, Xinxin Lin, Yuanxi Lin, Jiandong Lin, Xiongjian Xiao","doi":"10.1080/0886022X.2024.2368088","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In various disease contexts, magnesium abnormalities are associated with acute kidney injury (AKI) incidence. However, this association remains unclear and has not been systematically investigated in patients with cirrhosis. Hence, we aimed to elucidate the association between admission serum magnesium levels and AKI incidence in intensive care unit (ICU)-admitted cirrhotic patients.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using MIMIC-IV2.2 data, focusing on critically ill patients with cirrhosis. We employed univariable and multivariable logistic regression and restricted cubic spline analyses to robustly address our research objectives. To further substantiate the findings, subgroup and sensitivity analyses were also conducted.</p><p><strong>Results: </strong>Among the 3,228 enrolled ICU-admitted cirrhotic patients, 34.4% were female, and the overall AKI incidence was 68.6% (2,213/3,228). Multivariable logistic regression analysis revealed an independent relationship between elevated serum magnesium levels and increased AKI risk (OR = 1.55 [95% CI = 1.15-2.09], <i>p</i> = 0.004). Compared with individuals with serum magnesium levels < 1.6 mg/dL, individuals with serum magnesium levels in Q2 (1.6-2.6 mg/dL) and Q3 (≥2.6 mg/dL) had adjusted ORs for AKI of 1.89 (95% CI = 1.34-2.65, <i>p</i> < 0.001) and 2.19 (95% CI = 1.27-3.75, <i>p</i> = 0.005), respectively. The restricted cubic spline analysis revealed that AKI risk increased linearly with increasing serum magnesium levels. Subgroup analysis revealed that the association between serum magnesium levels and AKI incidence was remarkably stable in subgroup analysis (all <i>P</i><sub>interaction</sub> >0.05).</p><p><strong>Conclusions: </strong>High serum magnesium concentrations were significantly associated with an increased AKI risk in ICU-admitted patients with cirrhosis. Further randomized trials are needed to confirm this association.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"46 2","pages":"2368088"},"PeriodicalIF":3.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11308976/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between serum magnesium concentrations and the risk of developing acute kidney injury in patients with cirrhosis: a retrospective cohort study based on the MIMIC-IV database.\",\"authors\":\"Bingwen Lin, Wenbiao Xiao, Peng Huang, Xinxin Lin, Yuanxi Lin, Jiandong Lin, Xiongjian Xiao\",\"doi\":\"10.1080/0886022X.2024.2368088\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In various disease contexts, magnesium abnormalities are associated with acute kidney injury (AKI) incidence. However, this association remains unclear and has not been systematically investigated in patients with cirrhosis. Hence, we aimed to elucidate the association between admission serum magnesium levels and AKI incidence in intensive care unit (ICU)-admitted cirrhotic patients.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using MIMIC-IV2.2 data, focusing on critically ill patients with cirrhosis. We employed univariable and multivariable logistic regression and restricted cubic spline analyses to robustly address our research objectives. To further substantiate the findings, subgroup and sensitivity analyses were also conducted.</p><p><strong>Results: </strong>Among the 3,228 enrolled ICU-admitted cirrhotic patients, 34.4% were female, and the overall AKI incidence was 68.6% (2,213/3,228). Multivariable logistic regression analysis revealed an independent relationship between elevated serum magnesium levels and increased AKI risk (OR = 1.55 [95% CI = 1.15-2.09], <i>p</i> = 0.004). Compared with individuals with serum magnesium levels < 1.6 mg/dL, individuals with serum magnesium levels in Q2 (1.6-2.6 mg/dL) and Q3 (≥2.6 mg/dL) had adjusted ORs for AKI of 1.89 (95% CI = 1.34-2.65, <i>p</i> < 0.001) and 2.19 (95% CI = 1.27-3.75, <i>p</i> = 0.005), respectively. The restricted cubic spline analysis revealed that AKI risk increased linearly with increasing serum magnesium levels. Subgroup analysis revealed that the association between serum magnesium levels and AKI incidence was remarkably stable in subgroup analysis (all <i>P</i><sub>interaction</sub> >0.05).</p><p><strong>Conclusions: </strong>High serum magnesium concentrations were significantly associated with an increased AKI risk in ICU-admitted patients with cirrhosis. Further randomized trials are needed to confirm this association.</p>\",\"PeriodicalId\":20839,\"journal\":{\"name\":\"Renal Failure\",\"volume\":\"46 2\",\"pages\":\"2368088\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11308976/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Renal Failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/0886022X.2024.2368088\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Renal Failure","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/0886022X.2024.2368088","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/6 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：在各种疾病中，镁异常与急性肾损伤（AKI）的发生率有关。然而，这种关联性仍不明确，而且尚未对肝硬化患者进行系统研究。因此，我们旨在阐明重症监护病房（ICU）收治的肝硬化患者入院血清镁水平与急性肾损伤发生率之间的关系：我们利用 MIMIC-IV2.2 数据进行了一项回顾性队列研究，重点关注肝硬化重症患者。我们采用了单变量和多变量逻辑回归以及限制性立方样条分析来有力地实现我们的研究目标。为了进一步证实研究结果，我们还进行了亚组和敏感性分析：在 3,228 名入住 ICU 的肝硬化患者中，34.4% 为女性，总体 AKI 发生率为 68.6%（2,213/3,228）。多变量逻辑回归分析显示，血清镁水平升高与 AKI 风险增加之间存在独立关系（OR = 1.55 [95% CI = 1.15-2.09]，P = 0.004）。与血清镁水平<1.6 mg/dL的个体相比，血清镁水平在Q2（1.6-2.6 mg/dL）和Q3（≥2.6 mg/dL）的个体发生AKI的调整OR值分别为1.89（95% CI = 1.34-2.65，P = 0.005）。限制性三次样条分析显示，AKI 风险随血清镁水平的增加而线性增加。亚组分析显示，血清镁水平与 AKI 发生率之间的关系在亚组分析中非常稳定（所有 Pinteraction 均大于 0.05）：结论：在入住ICU的肝硬化患者中，高血清镁浓度与AKI风险增加显著相关。需要进一步的随机试验来证实这种关联。
Association between serum magnesium concentrations and the risk of developing acute kidney injury in patients with cirrhosis: a retrospective cohort study based on the MIMIC-IV database.
Background: In various disease contexts, magnesium abnormalities are associated with acute kidney injury (AKI) incidence. However, this association remains unclear and has not been systematically investigated in patients with cirrhosis. Hence, we aimed to elucidate the association between admission serum magnesium levels and AKI incidence in intensive care unit (ICU)-admitted cirrhotic patients.
Methods: A retrospective cohort study was conducted using MIMIC-IV2.2 data, focusing on critically ill patients with cirrhosis. We employed univariable and multivariable logistic regression and restricted cubic spline analyses to robustly address our research objectives. To further substantiate the findings, subgroup and sensitivity analyses were also conducted.
Results: Among the 3,228 enrolled ICU-admitted cirrhotic patients, 34.4% were female, and the overall AKI incidence was 68.6% (2,213/3,228). Multivariable logistic regression analysis revealed an independent relationship between elevated serum magnesium levels and increased AKI risk (OR = 1.55 [95% CI = 1.15-2.09], p = 0.004). Compared with individuals with serum magnesium levels < 1.6 mg/dL, individuals with serum magnesium levels in Q2 (1.6-2.6 mg/dL) and Q3 (≥2.6 mg/dL) had adjusted ORs for AKI of 1.89 (95% CI = 1.34-2.65, p < 0.001) and 2.19 (95% CI = 1.27-3.75, p = 0.005), respectively. The restricted cubic spline analysis revealed that AKI risk increased linearly with increasing serum magnesium levels. Subgroup analysis revealed that the association between serum magnesium levels and AKI incidence was remarkably stable in subgroup analysis (all Pinteraction >0.05).
Conclusions: High serum magnesium concentrations were significantly associated with an increased AKI risk in ICU-admitted patients with cirrhosis. Further randomized trials are needed to confirm this association.
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.
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