Creatinine clearence in renal recovery and mortality
DOI:
https://doi.org/10.55892/jrg.v7i14.930Keywords:
Acute Kidney Injury, Glomerular Filtration Rate, Hospitalization, Mortality, Recovery of FunctionAbstract
Objective: To verify the association of glomerular filtration rate based on the estimate of creatinine clearance with the occurrence of renal recovery and mortality in hospitalized patients with hospital-acquired acute kidney injury. Method: Prospective cohort of 202 patients followed between 2017 and 2019. The Mann-Whitney, Chi-square and Fisher's Exact tests were used for statistical analysis. The Backward method using logistic regression was used for multivariate analysis. Results with p≤0.05 were considered significant. Results: It was found that the median estimated glomerular filtration rate of 39.83 ml/min/1.73 m2 (from 29.15 to 61.64) was associated with hospital deaths (p=0.032) and recovery from long-term (6 months) renal function (AUC 0.756). Conclusion: Estimated variations in creatinine clearance were associated with long-term renal recovery and in-hospital deaths. Furthermore, an association was found between creatinine clearance and renal function with death during the hospitalization of patients in the ward with hospital-acquired acute kidney injury.
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ABEBE, A. et al. Mortality and predictors of acute kidney injury in adults: a hospital-based prospective observational study. Scientific Reports, v. 11, n. 1, p. 15672. 2021.
AGRESTI, A. Categorical Data Analysis. Technometrics, v. 45, n. 1, p. 109–109, 2012.
AKPINAR, K; ASLAN, D; FENKÇI, S. M. Assessment of estimated glomerular filtration rate based on cystatin C in diabetic nephropathy. Jornal Brasileiro de Nefrologia, v. 43, n. 3, p. 340–348, 2021.
BAUMANN, T.; STADDON, J.; HORST, M.; BIVINS, B. Minimum urine collection periods for accurate determination of creatinine clearance in critically ill patients. Clinical Pharmacy, v. 6, n. 5, p. 393–398, 1987.
BENTO, G. A. O. et al. Reduction of estimated glomerular filtration rate after COVID-19-associated acute kidney injury. Jornal Brasileiro de Nefrologia, v. 45, n. 4, p. 499-505, 2023.
CHAWLA, L. S. et al. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup. Nature Reviews Nephrology, v. 13, n. 4, p. 241–257, 2017.
CHEN, W. et al. The timing of continuous renal replacement therapy initiation in sepsis-associated acute kidney injury in the intensive care unit: the CRTSAKI Study (Continuous RRT Timing in Sepsis-associated AKI in ICU): study protocol for a multicentre, randomised cont. BMJ Open, v. 11, n. 2, p. e040718, 2021.
CUNHA, N. V. A. et al. Positive pressure on invasive mechanical ventilation and renal implications in critical patients. Revista de Enfermagem do Centro-Oeste Mineiro, v. 9, n. e3505, p. 1–9, 2019.
ENDRE, Z. H. Recovery from acute kidney injury: The role of biomarkers. Nephron - Clinical Practice. p. 101–105, 2014.
FIORENTINO, M. et al. Plasma Biomarkers in Predicting Renal Recovery from Acute Kidney Injury in Critically Ill Patients. Blood Purification, v. 48, n. 3, p. 253–261, 2019.
FORNI, L. G. et al. Renal recovery after acute kidney injury. Intensive Care Medicine, v. 43, n. 6, p. 855–866, 2017.
FORTRIE, G.; GEUS, H. R. H.; BETJES, M. G. H. The aftermath of acute kidney injury: a narrative review of long-term mortality and renal function. Critical Care, v. 23, n. 1, p. 24, 2019.
FREITAS, F. M. et al. The use of antimicrobials in septic patients with acute kidney injury. Jornal Brasileiro de Nefrologia, v. 39, n. 3, p. 323–328, 2017..
GODIN, M.; MACEDO, E.; MEHTA, R. L. Clinical determinants of renal recovery. Nephron - Clinical Practice. p. 25–29, 2014.
GOLDSTEIN, H. et al. Analysis of Longitudinal Data. Journal of the Royal Statistical Society. v. 158, n. 2, p. 345, 2002.
GRAZIANI, M. P. et al. Lesión renal aguda en niños poscirugía cardíaca: factores de riesgo e impacto evolutivo. Estudio de cohorte retrospectiva. Archivos Argentinos de Pediatria, v. 117, n. 6, p. 557–567, 2019.
HESSEY, E. et al. Renal Function Follow-Up and Renal Recovery After Acute Kidney Injury in Critically Ill Children*. Pediatric Critical Care Medicine, v. 18, n. 8, p. 733–740, 2017.
KASHANI, K. et al. Quality improvement goals for acute kidney injury. Clinical Journal of the American Society of Nephrology, v. 14, n. 6, p. 941–953, 2019.
KAUFMAN, D. P.; KNOHL, S. J. Physiology, Glomerular Filtration Rate (GFR)., 2023. E-book. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/29763208.
KDIGO. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease, 2013. Disponível em: https://kdigo.org/wp-content/uploads/2017/02/KDIGO_2012_CKD_GL.pdf
KELLUM, John A. et al. KDIGO clinical practice guideline for acute kidney injury. Kidney International. v. 2, n.1, Suppl, 2012.
KELLUM, John A. et al. Recovery after Acute Kidney Injury. American Journal of Respiratory and Critical Care Medicine, v. 195, n. 6, p. 784–791, 2017.
KIRWAN, C. J.; PHILIPS, B. J.; MACPHEE, I. A. M. Estimated glomerular filtration rate correlates poorly with four-hour creatinine clearance in critically ill patients with acute kidney injury. Critical Care Research and Practice, v. 2013, p. 1–8, 2013.
LAMEIRE, N. H. et al. Harmonizing acute and chronic kidney disease definition and classification: report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference. Kidney International, v. 100, n. 3, p. 516–526, 2021..
MACEDO, E.; BOUCHARD, J.; MEHTA, R. L. Renal recovery following acute kidney injury. Current Opinion in Critical Care, v. 14, n. 6, p. 660–665, 2008.
MALTA, D. C. et al. Avaliação da função renal na população adulta brasileira, segundo critérios laboratoriais da Pesquisa Nacional de Saúde. Revista Brasileira de Epidemiologia, v. 22, n. suppl 2, p. 1–13, 2019.
MARTÍN-DEL-CAMPO, F. et al. Morbid obesity is associated with mortality and acute kidney injury in hospitalized patients with COVID-19. Clinical Nutrition ESPEN, v. 45, p. 200–205, 2021.
MARTINELLO, F.; LIMA, L. M.; ANGHEBEM, M. IA importância da liberação da estimativa da taxa de filtração glomerular junto do resultado da creatinina sérica nos laudos. Revista Brasileira de Análises Clínicas, v. 53, n. 3, p. 311–315, 2021.
MOORE, P. K.; HSU, R.K.; LIU, K. D. Management of Acute Kidney Injury: Core Curriculum 2018. American Journal of Kidney Diseases, v. 72, n. 1, p. 136–148, 2018.
OSTERMANN, M. et al. Controversies in acute kidney injury: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference. Kidney International, v. 98, n. 2, p. 294–309, 2020.
OZRAZGAT-BASLANTI, T. et al. Association of persistent acute kidney injury and renal recovery with mortality in hospitalised patients. BMJ Health & Care Informatics, v. 28, n. 1, p. e100458, 2021.
PICKERING, J. W.; MELLAS, J. A simple method to detect recovery of glomerular filtration rate following acute kidney injury. BioMed Research International, v. 2014, 2014.
SHARMA, A.; MUCINO, M. J.; RONCO, C. Renal functional reserve and renal recovery after acute kidney injury. Nephron - Clinical Practice. p. 94–100, 2014.
SLIVNICK, J; LAMPERT, B. C. Hypertension and Heart Failure. Heart Failure Clinics, v. 15, n. 4, p. 531–541, 2019.
SRISAWAT, N; MURUGAN, R; KELLUM, J. A. Repair or progression after AKI: A role for biomarkers?. In: , 2014. Nephron - Clinical Practice. p. 185–189, 2014.
STROHBEHN, I. A. et al. Acute Kidney Injury Incidence, Recovery, and Long-term Kidney Outcomes Among Hospitalized Patients With COVID-19 and Influenza. Kidney International Reports, v. 6, n. 10, p. 2565–2574, 2021.
TAMAKI, M. et al. Lower glomerular filtration rate predicts increased hepatic and mucosal toxicity in myeloma patients treated with high-dose melphalan. International Journal of Hematology, v. 108, n. 4, p. 423–431, 2018.
VANMASSENHOVE, J. et al. Management of patients at risk of acute kidney injury. The Lancet, v. 389, n. 10084, p. 2139–2151, 2017.
WHO. Obesity: preventing and managing the global epidemic. In: Genebra: 1998. p. 275. E-book. Disponível em: https://apps.who.int/iris/bitstream/handle/10665/63854/WHO_NUT_NCD_98.1_%28p1-158%29.pdf?sequence=1&isAllowed=y.
YASHIRO, M. et al. Evaluation of estimated creatinine clearance before steady state in acute kidney injury by creatinine kinetics. Clinical and Experimental Nephrology, v. 16, n. 4, p. 570–579, 2012.
