Kidney Week

Abstract: PUB051

AKI Compared between Critically Ill Patients with Cirrhosis, Neoplasm, and Heart Failure

Session Information

• Publication Only

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Silva, Kelly, Sociedade Beneficente Israelita Brasileira Albert Einstein, Sao Paulo, São Paulo, Brazil

Kelly Silva

• Juliao, Maria Eduarda Braga, Faculdade Israelita Ciências de Saúde Albert Einstein, São Paulo, SP, Brazil

Maria Eduarda Braga Juliao

• Leoni, Stephanie Estevam, Faculdade Israelita Ciências de Saúde Albert Einstein, São Paulo, SP, Brazil

Stephanie Estevam Leoni

• Marchesini, Ana Carolina, Faculdade Israelita Ciências de Saúde Albert Einstein, São Paulo, SP, Brazil

Ana Carolina Marchesini

• Garcia, Carolina Suzuki, Universidade Federal de Sao Paulo Escola Paulista de Medicina, Sao Paulo, SP, Brazil

Carolina Suzuki Garcia

• Amaral Peixoto Rabelo, Cecília, Faculdade Israelita Ciências de Saúde Albert Einstein, São Paulo, SP, Brazil

Cecília Amaral Peixoto Rabelo, MS

• Arthur Ohannesian, Victor, Faculdade Israelita Ciências de Saúde Albert Einstein, São Paulo, SP, Brazil

Victor Arthur Ohannesian, MS

• Goes, Miguel Angelo, Faculdade Israelita Ciências de Saúde Albert Einstein, São Paulo, SP, Brazil

Miguel Angelo Goes, MD, PhD, FASN

Background

Acute kidney injury (AKI) might occur in critically ill patients in the ICU with cirrhosis (Cirrh), neoplasms (Neopl), and heart failure (HF). Thus, we studied and evaluated the frequency of AKI in these three conditions, and we also compared a subset of patients with AKI and without AKI in the HF group.

Methods

Our study, a retrospective analysis, meticulously examined 76 patients in the HF group, 27 in the Cirrh group, and 56 in the Neopl group admitted to the ICU. We compared demographic and clinical data, AKI development, and the need for kidney replacement therapy (KRT), mechanical ventilation, inotropes, and vasoactive drugs. Subsequently, we compared the subgroups with and without AKI from the HF group. Multivariate analysis was also performed, ensuring the robustness of our findings.

Results

The Cirrh group had higher total bilirubin levels and lower platelets. The HF group had higher serum urea and creatinine levels and a higher CKD frequency on admission. There also were higher inotrope requirements, development of AKI, and the need for KRT within 28 days of hospitalization. The subgroup of patients with HF and AKI had lower mean arterial pressure (MAP) and ejection fraction (34.6±2.1%, 51.8±2.2%; p<0.001) at hospital admission. While MAP, serum urea levels (OR 1.036; CI, 95% 1.006-1.067; p=0.02), and ejection fraction at hospital admission had an independent association with AKI in the HF group.

Conclusion

Our study's findings underscore the significant frequency of AKI in patients with HF. Moreover, we discovered that ejection fraction, MAP, and urea levels on admission were independently associated with AKI in critically ill patients with HF. These insights are crucial for understanding and managing AKI in this patient population.