Acute kidney injury in critically ill patients with pandemic influenza A pneumonia 2009 in Korea: a multicenter study.
Ji Ye Jung ; Byung Hoon Park ; Moo Suk Park ; Chang Young Lim ; Yeon-Sook Kim ; Ho Cheol Kim ; Yong Bum Park ; Hye Sook Choi ; Jae Hwa Cho ; Jae Yeol Kim ; Shin Ok Koh ; Kyeongman Jeon ; Gee Young Suh ; Younsuck Koh ; Sang-Bum Hong
Journal of Critical Care, Vol.26(6) : 577~585, 2011
Journal of Critical Care
OBJECTIVES: We assessed the incidence and clinical characteristics of acute kidney injury (AKI) in critically ill patients infected with pandemic influenza A (H1N1) and its effect on clinical outcomes.
METHODS: We conducted a multicenter, retrospective, observational study of patients with pandemic H1N1-related critical illness admitted to intensive care units (ICUs) of 28 tertiary or referral hospitals in South Korea between September 1, 2009, and February 28, 2010. Outcomes were AKI within 72 hours after ICU admission and 30-day mortality. Acute kidney injury was defined according to the Risk, Injury, Failure, Loss, and End-stage renal failure criteria.
RESULTS: Of the 221 patients, 50 (22.6%) developed AKI within 72 hours after ICU admission. Independent risk factors for AKI were age (odds ratio [OR], 1.05; P = .003), chronic kidney disease (OR, 14.82; P = .004), and Sequential Organ Failure Assessment score (OR, 1.45; P < .001). Age (OR, 1.04; P = .003), Sequential Organ Failure Assessment score (OR, 1.28; P = .012), state of immune suppression (OR, 4.09; P = .01), mechanical ventilation (OR, 18.24; P = .001), corticosteroid use (OR, 3.09; P = .007), and AKI (OR, 2.86; P = .035) were significantly associated with 30-day mortality.
CONCLUSIONS: A significant number of patients with H1N1-related critical illness developed AKI within 72 hours of ICU admission, and this early development of AKI was associated with 30-day mortality.