Abstract
BackgroundAcute kidney injury (AKI) is a frequent complication of community acquired pneumonia (CAP). However, the impact of AKI on in-hospital outcomes of patients with CAP in the Chinese population remains unclear.MethodsPatients diagnosed with CAP were evaluated in this retrospective observational study. Multiple Cox regression models were employed to identify the association between AKI and in-hospital mortality and 30-day mortality, respectively.ResultsA total of 4213 patients were recruited; 950 (22.5%) patients were diagnosed with AKI. Independent risk factors for AKI were age, male gender, hypertension, cardiac dysfunction, diabetes, chronic kidney disease, acute respiratory failure, use of diuretics, use of vasoactive drugs, and CURB-65. Cox proportional hazards regression revealed AKI, use of angiotensin receptor blocker, hypertension, CURB-65, acute respiratory failure, and use of vasoactive drugs to be independent risk factors for both in-hospital and 30-day mortality. Compared to patients without AKI, those suffering AKI were found to have 1.31-fold (HR 1.31, 95% CI, 1.04–1.66; P = 0.023) and 1.29-fold (HR 1.29, 95% CI, 1.02–1.62; P = 0.033) increased in-hospital and 30-day mortality risks, respectively. In addition, patients with AKI were likely to require admission to intensive care unit (ICU) (42.9% versus 11.4%; P < 0.001), mechanical ventilation (33.8% versus 9.3%; P < 0.001), invasive mechanical ventilation (25.9% versus 5.8%; P < 0.001), non-invasive mechanical ventilation (25.4% versus 7.1%; P < 0.001), and experienced a longer duration of hospital stay (14 days versus 10 days; P < 0.001) than those without AKI. However, no significant difference in ICU stay (11 days versus 10 days; P = 0.099) and duration of mechanical ventilation (8 days versus 8 days; P = 0.369) between AKI and non-AKI groups was found.ConclusionAKI was common in Chinese patients with CAP. Patients with CAP who developed AKI had worse in-hospital outcomes.
Highlights
Acute kidney injury (AKI) is a frequent complication of community acquired pneumonia (CAP)
chronic obstructive pulmonary disease (COPD), hypertension, atrial fibrillation, cardiac dysfunction, diabetes, chronic kidney disease, and cerebrovascular disease were more common in the AKI group
Independent risk factors for AKI included age, male gender, hypertension, cardiac dysfunction, diabetes, chronic kidney disease, acute respiratory failure, use of diuretics, use of vasoactive drugs, and CURB-65 (Table 2)
Summary
Acute kidney injury (AKI) is a frequent complication of community acquired pneumonia (CAP). Community acquired pneumonia (CAP) is a leading cause of infectious death globally [1, 2]. The number of patients hospitalized with CAP in the USA is estimated to have increased to 1 million in 2020, with large increases globally [3, 4]. Acute kidney injury (AKI) is a frequent complication of CAP; the incidence of AKI in CAP patients was reported to range from 18 to 34% [6,7,8]. The impact of AKI on in-hospital outcomes of CAP patients in the Chinese population remains unclear
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