Investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantation

Objective The purpose of this study was to investigate the correlation between different subtypes of acute kidney injury (AKI) and clinical outcomes following lung transplantation (LTx) and to identify a reliable indicator for predicting poor prognosis in the LTx population.Methods We retrospectivel...

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Main Authors: Wenwen Du, Dan Zhang, Wenqian Chen, Wenhui Chen, Pengmei Li, Xiaoxing Wang
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2024.2406403
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author Wenwen Du
Dan Zhang
Wenqian Chen
Wenhui Chen
Pengmei Li
Xiaoxing Wang
author_facet Wenwen Du
Dan Zhang
Wenqian Chen
Wenhui Chen
Pengmei Li
Xiaoxing Wang
author_sort Wenwen Du
collection DOAJ
description Objective The purpose of this study was to investigate the correlation between different subtypes of acute kidney injury (AKI) and clinical outcomes following lung transplantation (LTx) and to identify a reliable indicator for predicting poor prognosis in the LTx population.Methods We retrospectively analyzed the clinical data of 279 LTx patients from August 2016 to March 2023. The AKI subtypes included AKI, persistent AKI on Day 7 (P7-AKI) and Day 14 (P14-AKI) after LTx, and AKI stages. The correlations of these factors with respiratory outcomes, mortality at 90 days, mortality at 1 year and data finalization were assessed, and the risk factors for the selected AKI subtypes were evaluated.Results AKI occurred in 215 patients (77.1%), with 129 (46.2%) experiencing P7-AKI and 95 (34.1%) experiencing P14-AKI. P7-AKI was associated with more respiratory and mortality outcomes than were AKI and AKI stages, and P7-AKI surpassed P14-AKI in terms of a shorter diagnostic time. After adjusting for age, sex, BMI, type of transplant, transplant diagnosis and comorbidities, P7-AKI independently correlated with increased mortality risk at 90 days [HR 12.312 (95% CI: 2.839–53.402)], 1 year [HR 3.847 (95% CI: 1.840–8.044)], and data finalization [HR 2.010 (95% CI: 1.331–3.033)]. Five variables were identified as independent predictors for P7-AKI, including preoperative body mass index, prothrombin activity, hemoglobin and serum creatinine, and intraoperative colloid administration.Conclusion P7-AKI has been identified as a reliable indicator for predicting adverse outcomes in LTx patients, which may assist healthcare professionals in identifying high-risk individuals.
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spelling doaj-art-599acbae84da4d13989508ff0993f14d2025-08-20T02:29:56ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2406403Investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantationWenwen Du0Dan Zhang1Wenqian Chen2Wenhui Chen3Pengmei Li4Xiaoxing Wang5Department of Pharmacy, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Pharmacy, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Pharmacy, China-Japan Friendship Hospital, Beijing, ChinaNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Lung Transplantation, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Pharmacy, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Pharmacy, China-Japan Friendship Hospital, Beijing, ChinaObjective The purpose of this study was to investigate the correlation between different subtypes of acute kidney injury (AKI) and clinical outcomes following lung transplantation (LTx) and to identify a reliable indicator for predicting poor prognosis in the LTx population.Methods We retrospectively analyzed the clinical data of 279 LTx patients from August 2016 to March 2023. The AKI subtypes included AKI, persistent AKI on Day 7 (P7-AKI) and Day 14 (P14-AKI) after LTx, and AKI stages. The correlations of these factors with respiratory outcomes, mortality at 90 days, mortality at 1 year and data finalization were assessed, and the risk factors for the selected AKI subtypes were evaluated.Results AKI occurred in 215 patients (77.1%), with 129 (46.2%) experiencing P7-AKI and 95 (34.1%) experiencing P14-AKI. P7-AKI was associated with more respiratory and mortality outcomes than were AKI and AKI stages, and P7-AKI surpassed P14-AKI in terms of a shorter diagnostic time. After adjusting for age, sex, BMI, type of transplant, transplant diagnosis and comorbidities, P7-AKI independently correlated with increased mortality risk at 90 days [HR 12.312 (95% CI: 2.839–53.402)], 1 year [HR 3.847 (95% CI: 1.840–8.044)], and data finalization [HR 2.010 (95% CI: 1.331–3.033)]. Five variables were identified as independent predictors for P7-AKI, including preoperative body mass index, prothrombin activity, hemoglobin and serum creatinine, and intraoperative colloid administration.Conclusion P7-AKI has been identified as a reliable indicator for predicting adverse outcomes in LTx patients, which may assist healthcare professionals in identifying high-risk individuals.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2406403Acute kidney injurypersistent acute kidney injuryAKI stageslung transplantationmortality
spellingShingle Wenwen Du
Dan Zhang
Wenqian Chen
Wenhui Chen
Pengmei Li
Xiaoxing Wang
Investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantation
Renal Failure
Acute kidney injury
persistent acute kidney injury
AKI stages
lung transplantation
mortality
title Investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantation
title_full Investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantation
title_fullStr Investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantation
title_full_unstemmed Investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantation
title_short Investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantation
title_sort investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantation
topic Acute kidney injury
persistent acute kidney injury
AKI stages
lung transplantation
mortality
url https://www.tandfonline.com/doi/10.1080/0886022X.2024.2406403
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