Renal impairment and in-hospital adverse renal events in critically ill patients assessed by age-adapted estimated glomerular filtration rate criteria
Background Impaired renal function (IRF) is associated with an elevated risk of major adverse renal events (MARE). However, the relationship between age-adapted estimated glomerular filtration rate (eGFR) criteria and in-hospital MARE has not been extensively studied in critically ill patients. Furt...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2456110 |
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| author | Chong Zhang Weiru Liang Meng Ning Bin Su Tingting Guo Kun Hu Wei Su Yi Chen Wenjin Peng Yingwu Liu |
| author_facet | Chong Zhang Weiru Liang Meng Ning Bin Su Tingting Guo Kun Hu Wei Su Yi Chen Wenjin Peng Yingwu Liu |
| author_sort | Chong Zhang |
| collection | DOAJ |
| description | Background Impaired renal function (IRF) is associated with an elevated risk of major adverse renal events (MARE). However, the relationship between age-adapted estimated glomerular filtration rate (eGFR) criteria and in-hospital MARE has not been extensively studied in critically ill patients. Furthermore, the impact of eGFR trajectory changes on in-hospital MARE in this patient population remains underexplored.Methods In this study, we analyzed data from 7,423 critically ill patients using version 2.2 of the Medical Information Mart for Intensive Care IV database. Based on the age-adapted eGFR criteria, renal function status was classified as impaired renal function (IRF), subclinical impairment of renal function (SIRF), and normal renal function (NRF).Results There were 2,438 patients (32.8%) of in-hospital MARE. The incidence of MARE and their individual endpoint components was higher in patients with SIRF and IRF than in patients with NRF. Group-based trajectory modeling revealed that, compared with patients with other renal function status, patients with SIRF demonstrated the most significant decline in eGFR as well as the highest risk of MARE based on the results of the low-level-to-decline trajectory. Additionally, a trend toward an increased risk of MARE was observed in patients with SIRF and IRF, particularly among younger patients, when compared with those with NRF.Conclusions Critically ill patients with SIRF and IRF had an increased risk of in-hospital MARE. Patients with SIRF experienced the most notable decline in renal function during hospitalization, with the highest risk of MARE noted in this trajectory group. In addition, a trend toward an increased risk of MARE was observed in younger patients. Consequently, active monitoring and timely intervention in younger patients are imperative. |
| format | Article |
| id | doaj-art-fc1e4d543ddd496593d209a649bdbe58 |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-fc1e4d543ddd496593d209a649bdbe582025-02-05T04:01:20ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2456110Renal impairment and in-hospital adverse renal events in critically ill patients assessed by age-adapted estimated glomerular filtration rate criteriaChong Zhang0Weiru Liang1Meng Ning2Bin Su3Tingting Guo4Kun Hu5Wei Su6Yi Chen7Wenjin Peng8Yingwu Liu9The Third Central Clinical College of Tianjin Medical University, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaThe Third Central Clinical College of Tianjin Medical University, Tianjin, ChinaThe Third Central Clinical College of Tianjin Medical University, Tianjin, ChinaThe Third Central Clinical College of Tianjin Medical University, Tianjin, ChinaThe Third Central Clinical College of Tianjin Medical University, Tianjin, ChinaThe Third Central Clinical College of Tianjin Medical University, Tianjin, ChinaThe Third Central Clinical College of Tianjin Medical University, Tianjin, ChinaThe Third Central Clinical College of Tianjin Medical University, Tianjin, ChinaThe Third Central Clinical College of Tianjin Medical University, Tianjin, ChinaBackground Impaired renal function (IRF) is associated with an elevated risk of major adverse renal events (MARE). However, the relationship between age-adapted estimated glomerular filtration rate (eGFR) criteria and in-hospital MARE has not been extensively studied in critically ill patients. Furthermore, the impact of eGFR trajectory changes on in-hospital MARE in this patient population remains underexplored.Methods In this study, we analyzed data from 7,423 critically ill patients using version 2.2 of the Medical Information Mart for Intensive Care IV database. Based on the age-adapted eGFR criteria, renal function status was classified as impaired renal function (IRF), subclinical impairment of renal function (SIRF), and normal renal function (NRF).Results There were 2,438 patients (32.8%) of in-hospital MARE. The incidence of MARE and their individual endpoint components was higher in patients with SIRF and IRF than in patients with NRF. Group-based trajectory modeling revealed that, compared with patients with other renal function status, patients with SIRF demonstrated the most significant decline in eGFR as well as the highest risk of MARE based on the results of the low-level-to-decline trajectory. Additionally, a trend toward an increased risk of MARE was observed in patients with SIRF and IRF, particularly among younger patients, when compared with those with NRF.Conclusions Critically ill patients with SIRF and IRF had an increased risk of in-hospital MARE. Patients with SIRF experienced the most notable decline in renal function during hospitalization, with the highest risk of MARE noted in this trajectory group. In addition, a trend toward an increased risk of MARE was observed in younger patients. Consequently, active monitoring and timely intervention in younger patients are imperative.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2456110Critically ill patientsgroup-based trajectory modelingimpaired renal functionmajor adverse renal eventssubclinical impairment of renal function |
| spellingShingle | Chong Zhang Weiru Liang Meng Ning Bin Su Tingting Guo Kun Hu Wei Su Yi Chen Wenjin Peng Yingwu Liu Renal impairment and in-hospital adverse renal events in critically ill patients assessed by age-adapted estimated glomerular filtration rate criteria Renal Failure Critically ill patients group-based trajectory modeling impaired renal function major adverse renal events subclinical impairment of renal function |
| title | Renal impairment and in-hospital adverse renal events in critically ill patients assessed by age-adapted estimated glomerular filtration rate criteria |
| title_full | Renal impairment and in-hospital adverse renal events in critically ill patients assessed by age-adapted estimated glomerular filtration rate criteria |
| title_fullStr | Renal impairment and in-hospital adverse renal events in critically ill patients assessed by age-adapted estimated glomerular filtration rate criteria |
| title_full_unstemmed | Renal impairment and in-hospital adverse renal events in critically ill patients assessed by age-adapted estimated glomerular filtration rate criteria |
| title_short | Renal impairment and in-hospital adverse renal events in critically ill patients assessed by age-adapted estimated glomerular filtration rate criteria |
| title_sort | renal impairment and in hospital adverse renal events in critically ill patients assessed by age adapted estimated glomerular filtration rate criteria |
| topic | Critically ill patients group-based trajectory modeling impaired renal function major adverse renal events subclinical impairment of renal function |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2025.2456110 |
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