Risk factors and outcomes of early acute kidney injury in infective endocarditis: A retrospective cohort study

International Journal of Infectious Diseases

Laurent Fauchier¹  Adrien Lemaignen²  Bénédicte Sautenet³  Jean-Michel Halimi⁴  Thierry Bourguignon⁵  Antoine Portais⁶  Florent Von Tokarski⁶  Fanny Hennekinne⁶  Annick Legras⁷  Frédéric Patat⁷  Anne Bernard⁸  Louis Bernard⁹  Christian Mirguet^1,10 

[1] Corresponding author at: Service de Médecine interne et maladies infectieuses, Hôpital Bretonneau, CHRU de Tours, 2, Boulevard Tonnellé, 37 044 CEDEX 9, Tours, France.;Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, France;Service de Cardiologie, France;Service de Gériatrie, France;Service de Médecine Intensive, France;Service de Médecine interne et Maladies Infectieuses, France;Service de Néphrologie-HTA, Dialyses, Transplantation Rénale, France;Service de chirurgie cardio-vasculaire, France;Service de réanimation cardio-vasculaire, CHRU de Tours, Tours, France;Service d’échographie, France;

关键词: Infective endocarditis;    Acute kidney injury;    Outcome;    Infectious diseases team;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objectives: The incidence of acute kidney injury (AKI) in infective endocarditis (IE), its risk factors and consequences on patient and renal survival remain debated. Methods: Patients hospitalized for a first episode of IE (possible or definite according to modified Duke criteria) between 2013 and 2016 were included. The primary endpoint was to determine risk factors for early AKI (E-AKI) during the first week of management of IE. Results: A total of 276 patients were included: 220 (79.7%) had definite IE and 56 (20.3%) had possible IE. E-AKI occurred in 150 patients (53%). IE due to Staphylococcus aureus (OR 3.41; 95% CI 1.83–6.39; p < 0.01), history of diabetes (OR 2.34; 95% CI 1.25–4.37; p < 0.01), peripheral arterial disease (OR 2.59; 95% CI 1.07–6.23; p < 0.05), immunological manifestations (OR 3.11; 95% CI 1.31–7.39; p = 0.01), and use of norepinephrine (OR 3.44; 95% CI 1.72–7.02; p < 0.01) were associated with E-AKI. In subgroup analysis, infectious disease consultation was associated with a lower risk of AKI at day 7 (OR 0.41; 95% CI 0.16–0.88; p = 0.04). E-AKI was associated with 1-year mortality (OR 1.65; 95% CI 1.03–2.64; p = 0.04) and chronic kidney disease progression (OR 2.23; 95% CI 1.30–3.82; p < 0.01). Conclusions: E-AKI is common in IE and often associated with non-modifiable variables. Multidisciplinary management should be mandatory, and awareness of AKI diagnosis and etiological explorations should be raised.

【 授权许可】

Unknown