Factors Associated with Acute Kidney Injury in Community-Acquired Pneumonia: Development of a Probabilistic Clinical Model

• Autor(a) principal: Teles, Carolina
• Data de Publicação: 2023
• Outros Autores: Magalhães, Ana, Dias da Costa, Tiago, Barra, Cátia, Silva, Ana Luísa, Albuquerque, Fernando, Gaspar, Elsa, Santos, Lèlita
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.24950/rspmi.1401
• topic: Infecções Comunitárias Adquiridas/ complicações; Lesão Renal Aguda/diagnóstico; Lesão Renal Aguda/etiologia; Pneumonia/complicações; Prognóstico; Acute Kidney Injury/diagnosis; Acute Kidney Injury/etiology; Community-Acquired Infections/complications; Pneumonia/complications; Prognosis

Introduction: Acute kidney injury (AKI) is a frequent complication of community-acquired pneumonia (CAP). Nonetheless, the underlying pathophysiology is not fully understood. Certain factors have shown association with increased risk, but there is still data lacking. The main objective of this study was to identify factors associated with AKI in CAP. Methods: We conducted a retrospective study in patients with confirmed CAP, admitted to an Internal Medicine department within a period of 1 year, presenting with or without AKI on admission. We performed comparative statistics between non-AKI and AKI patients, univariate and multivariable logistic regression with odds ratio (OR) calculation, and survival analysis. Results: This study included 578 patients, of which 52.4% were male, had a mean age of 81.70±11.54 years, and 41.3% had AKI. The mean age was higher in the AKI group (p<0.001), with no differences for gender. In the univariate analysis, several comorbidities, drugs, diastolic blood pressure and some gasometric parameters showed association with AKI. The multivariable analysis selected seven variables as independent associated factors: age (OR 1.027), hyperuricemia (OR 1.990), chronic kidney disease (OR 3.138), diuretic (OR 1.555), statin (OR 1.805), diastolic blood pressure (OR 0.978) and serum lactate (OR 1.350), enabling the development of an AKI probabilistic model with a specificity of 81.1%. Conclusion: This study confirmed previous findings and identified new factors associated with AKI, namely serum lactate. The multivariable model represents a starting point for the creation of true predictive indexes of AKI in CAP with clinical applicability and impact on the therapeutic approach and prognosis.