Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/16719
Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection
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AuthorMartin-Loeches, Ignacio; Papiol, Elisabeth; Rodriguez, Alejandro; Diaz, Emili; Zaragoza, Rafael; Maria Granada, Rosa; Socias Crespi, Lorenzo ; Bonastre, Juan; Valverdu, Montserrat; Carlos Pozo, Juan; Luque, Pilar; Antonio Julia-Narvaez, Jose; Cordero, Lourdes; Albaya, Antonio; Seron, Daniel; Rello, Jordi; H1N1 SEMICYUC Working Grp
Document typeresearch article
CitationMartin-Loeches I, Papiol E, Rodriguez A, Diaz E, Zaragoza R, Granada RM, et al. Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection. Crit Care. 2011;15(1):R66.
Introduction: Little information exists about the impact of acute kidney injury (AKI) in critically ill patients with the pandemic 2009 influenza A (H1N1) virus infection. Methods: We conducted a prospective, observational, multicenter study in 148 Spanish intensive care units (ICUs). Patients with chronic renal failure were excluded. AKI was defined according to Acute Kidney Injury Network (AKIN) criteria. Results: A total of 661 patients were analyzed. One hundred eighteen (17.7%) patients developed AKI; of these, 37 (31.4%) of the patients with AKI were classified as AKI I, 15 (12.7%) were classified as AKI II and 66 (55.9%) were classified as AKI III, among the latter of whom 50 (75.7%) required continuous renal replacement therapy. Patients with AKI had a higher Acute Physiology and Chronic Health Evaluation II score (19.2 +/- 8.3 versus 12.6 +/- 5.9; P < 0.001), a higher Sequential Organ Failure Assessment score (8.7 +/- 4.2 versus 4.8 +/- 2.9; P < 0.001), more need for mechanical ventilation (MV) (87.3% versus 56.2%; P < 0.01, odds ratio (OR) 5.3, 95% confidence interval (CI) 3.0 to 9.4), a greater incidence of shock (75.4% versus 38.3%; P < 0.01, OR 4.9, 95% CI, 3.1 to 7.7), a greater incidence of multiorgan dysfunction syndrome (92.4% versus 54.7%; P < 0.01, OR 10.0, 95% CI, 4.9 to 20.21) and a greater incidence of coinfection (23.7% versus 14.4%; P < 0.01, OR 1.8, 95% CI, 1.1 to 3.0). In survivors, patients with AKI remained on MV longer and ICU and hospital length of stay were longer than in patients without AKI. The overall mortality was 18.8% and was significantly higher for AKI patients (44.1% versus 13.3%; P < 0.01, OR 5.1, 95% CI, 3.3 to 7.9). Logistic regression analysis was performed with AKIN criteria, and it demonstrated that among patients with AKI, only AKI III was independently associated with higher ICU mortality (P < 0.001, OR 4.81, 95% CI 2.17 to 10.62). Conclusions: In our cohort of patients with H1N1 virus infection, only those cases in the AKI III category were independently associated with mortality.
MeSHIntensive Care Units
Acute Kidney Injury
Influenza A Virus, H1N1 Subtype
DeCSLesión Renal Aguda
Subtipo H1N1 del Virus de la Influenza A
Persona de Mediana Edad
Unidades de Cuidados Intensivos