Acute Kidney Injury Linked to ARDS
Critically ill patients with acute respiratory distress syndrome are at 11 times increased risk of AKI.
Acute respiratory distress syndrome (ARDS) may increase critically ill patients' risk of acute kidney injury (AKI), a new study suggests.
The study included 8,029 patients treated in 18 intensive care units. ARDS was present in 1,879. AKI occurred in 31.3% of patients and occurred significantly more frequently in those with ARDS than without (44.3% vs. 27.4%). After adjusting for confounders, ARDS was independently associated with an 11 times increased risk of AKI compared with patients not on mechanical ventilation (reference group), researchers reported online ahead of print in the Clinical Journal of the American Society of Nephrology. The study also identified mechanical ventilation in the absence of ARDS as an independent risk factor for AKI, increasing AKI risk by more than 4-fold. The hospital mortality rate was significantly higher among those with ARDS compared with those who did not have ARDS (27.9% vs. 10.0%). Among patients with AKI, ARDS was associated with a higher mortality rate (42.3% vs. 20.2%).
“Our results support the addition of ARDS to the list of risk factors for AKI in critically ill patients,” the authors concluded.
The investigators, led by Michael Darmon, MD, of Saint Etienne University Hospital in Jarez, France, noted that the observational design of the study only allowed them “to conclude that ARDS was independently associated with AKI. No conclusions can be drawn about the causal nature of this association, despite the numerous experimental studies suggesting causality.”