Proteinuria and hematuria are associated with acute kidney injury and mortality in critically ill patients: a retrospective observational study

BMC Nephrology

Sejoong Kim³  Dong-Wan Chae¹  Ki Young Na¹  Ho Jun Chin¹  Seon Ha Baek¹  Jiwon Ryu⁴  Shin Young Ahn¹  Seung Seok Han² 

[1] Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea;Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea;Department of Biomedical Engineering, University of Michigan, Ann Arbor, USA;Department of Internal Medicine, Hallym University College of Medicine, Chuncheon-si, Gangwon-do, Korea

关键词: Proteinuria;    Mortality;    Intensive care unit;    Hematuria;    Acute kidney injury;   

Others  :  1082669
DOI  :  10.1186/1471-2369-15-93

 received in 2013-12-21, accepted in 2014-05-23,  发布年份 2014

【 摘 要 】

Background

Proteinuria and hematuria are both important health issues; however, the nature of the association between these findings and acute kidney injury (AKI) or mortality remains unresolved in critically ill patients.

Methods

Proteinuria and hematuria were measured by a dipstick test and scored using a scale ranging from a negative result to 3+ in 1883 patients admitted to the intensive care unit. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The odds ratios (ORs) for AKI and 3-year mortality were calculated after adjustment for multiple covariates according to the degree of proteinuria or hematuria. For evaluating the synergistic effect on mortality among proteinuria, hematuria, and AKI, the relative excess risk due to interaction (RERI) was used.

Results

Proteinuria and hematuria increased the ORs for AKI: the ORs of proteinuria were 1.66 (+/−), 1.86 (1+), 2.18 (2+), and 4.74 (3+) compared with non-proteinuria; the ORs of hematuria were 1.31 (+/−), 1.58 (1+), 2.63 (2+), and 2.52 (3+) compared with non-hematuria. The correlations between the mortality risk and proteinuria or hematuria were all significant and graded (Ptrend < 0.001). There was a relative excess risk of mortality when both AKI and proteinuria or hematuria were considered together: the synergy indexes were 1.30 and 1.23 for proteinuria and hematuria, respectively.

Conclusions

Proteinuria and hematuria are associated with the risks of AKI and mortality in critically ill patients. Additionally, these findings had a synergistic effect with AKI on mortality.

【 授权许可】

   
2014 Han et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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