INCREASE IN CHLORIDE IS ASSOCIATED WITH MAJOR ADVERSE KIDNEY EVENTS IN CRITICALLY ILL PATIENTS
Purpose: This study aimed to identify the association between hyperchloremia at intensive care unit (ICU) admission and/or the increase of blood chloride levels and the incidence of major adverse kidney events within 30 days (MAKE30) in critically ill adults. Methods: We conducted a retrospective st...
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| Veröffentlicht in: | Shock (Augusta, Ga.) Ga.), 2023-03, Vol.59 (3), p.338-343 |
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| creator | Zhou, Dingxin Jiang, Jun Zhang, Jing Cao, Fengsheng Peng, Zhiyong |
| description | Purpose: This study aimed to identify the association between hyperchloremia at intensive care unit (ICU) admission and/or the increase of blood chloride levels and the incidence of major adverse kidney events within 30 days (MAKE30) in critically ill adults. Methods: We conducted a retrospective study to analyze the data of all adult patients admitted to the ICU of a tertiary academic hospital in China between April 2020 and April 2022. Patients were categorized based on their admission chloride levels (hyperchloremia ≥110 mmol/L and nonhyperchloremia |
| doi_str_mv | 10.1097/SHK.0000000000002062 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2746393006</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2746393006</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3523-25e47fc77f7c0198c7701ff218ed9254fe900a73280f2106fc770792b99676763</originalsourceid><addsrcrecordid>eNpdkV9PwjAUxRujEUW_gTF99GV4224rfVzGlMoEs00MLy5jdAEdgisL8dvbCf6Jtw89aX_n9uYUoQsCHQKCX8f9QQf-FAWXHqAT4thggUPsQ6OBM4sySlvoVOsXw9hM8GPUYq7tONQlJ-hZDv0o8OIAyyH2--Eokj2jY-zF8ciXXhL08JNM-vjeuxtF2OuNg8jAA9kbBhMcjINhEn9ZI5lI3wvDCZZhiB-8RDZXZ-ioyEqtzvd7Gz3eBInft8LRbYNbOXOomdFRNi9yzgueAxFdo4AUBSVdNRPUsQslADLOaBfMIbgNClzQqRAuN4u10dWu77pavddKb9LlQueqLLM3tap1SrntMsEAGtTeoXm10rpSRbquFsus-kgJpE2yqUk2_Z-ssV3uX6inSzX7MX1H-dt3uyo3qtKvZb1VVTpXWbmZN_1M-F1qUaAMzCDmk0wx9glUhHh1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2746393006</pqid></control><display><type>article</type><title>INCREASE IN CHLORIDE IS ASSOCIATED WITH MAJOR ADVERSE KIDNEY EVENTS IN CRITICALLY ILL PATIENTS</title><source>MEDLINE</source><source>Journals@Ovid LWW Legacy Archive</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Zhou, Dingxin ; Jiang, Jun ; Zhang, Jing ; Cao, Fengsheng ; Peng, Zhiyong</creator><creatorcontrib>Zhou, Dingxin ; Jiang, Jun ; Zhang, Jing ; Cao, Fengsheng ; Peng, Zhiyong</creatorcontrib><description>Purpose: This study aimed to identify the association between hyperchloremia at intensive care unit (ICU) admission and/or the increase of blood chloride levels and the incidence of major adverse kidney events within 30 days (MAKE30) in critically ill adults. Methods: We conducted a retrospective study to analyze the data of all adult patients admitted to the ICU of a tertiary academic hospital in China between April 2020 and April 2022. Patients were categorized based on their admission chloride levels (hyperchloremia ≥110 mmol/L and nonhyperchloremia <110 mmol/L) and stratified on the increased chloride levels 48 h after ICU admission (∆Cl ≥5 mmol/L and ∆Cl <5 mmol/L). The primary outcome was the MAKE30 incidence, including in-hospital death, new receipt of renal replacement therapy (RRT), and persistent renal dysfunction (PRD). Association between hyperchloremia at ICU admission and/or the increase of chloride and the incidence of MAKE30 were assessed using logistic regression. Result: A total of 2,024 patients with a median age of 67 years (interquartile range [IQR], 55-76 years) and a median Acute Physiology and Chronic Health Evaluation II score of 22 (IQR, 17-28) were included. Hyperchloremia occurred in 30.9% (n = 625), and ΔCl ≥5 mmol/L occurred in 18.5% (n = 375) of all ICU patients. The overall MAKE30 incidence was 33.6% (n = 680), including a 10.9% of 30-day hospital mortality (n = 220; as well as overall in-hospital mortality, 11.8% [n = 238]), a 20.2% (n = 408) of PRD, and a 18.0% (n = 365) of new RRT. After adjusted for confounders, it was found that ΔCl ≥5 mmol/L (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.096-1.93; P = 0.010), but not hyperchloremia (OR, 0.99; 95% CI, 0.77-1.28; P = 0.947), was associated with increased incidence of MAKE30. Conclusion: An increased chloride level in the first 48 h of ICU admission was an independent risk factor for MAKE30, whereas hyperchloremia at ICU admission was not associated with an increased incidence of MAKE30. Large-scale prospective studies are needed to verify our findings.</description><identifier>ISSN: 1073-2322</identifier><identifier>EISSN: 1540-0514</identifier><identifier>DOI: 10.1097/SHK.0000000000002062</identifier><identifier>PMID: 36455261</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Acute Kidney Injury ; Adult ; Aged ; Chlorides ; Critical Illness ; Hospital Mortality ; Humans ; Intensive Care Units ; Kidney ; Middle Aged ; Retrospective Studies ; Water-Electrolyte Imbalance</subject><ispartof>Shock (Augusta, Ga.), 2023-03, Vol.59 (3), p.338-343</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>Copyright © 2023 by the Shock Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3523-25e47fc77f7c0198c7701ff218ed9254fe900a73280f2106fc770792b99676763</citedby><cites>FETCH-LOGICAL-c3523-25e47fc77f7c0198c7701ff218ed9254fe900a73280f2106fc770792b99676763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf><![CDATA[$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&PDF=y&D=ovft&AN=00024382-202303000-00003$$EPDF$$P50$$Gwolterskluwer$$H]]></linktopdf><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00024382-202303000-00003$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>314,780,784,4609,27924,27925,64666,65461</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36455261$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, Dingxin</creatorcontrib><creatorcontrib>Jiang, Jun</creatorcontrib><creatorcontrib>Zhang, Jing</creatorcontrib><creatorcontrib>Cao, Fengsheng</creatorcontrib><creatorcontrib>Peng, Zhiyong</creatorcontrib><title>INCREASE IN CHLORIDE IS ASSOCIATED WITH MAJOR ADVERSE KIDNEY EVENTS IN CRITICALLY ILL PATIENTS</title><title>Shock (Augusta, Ga.)</title><addtitle>Shock</addtitle><description>Purpose: This study aimed to identify the association between hyperchloremia at intensive care unit (ICU) admission and/or the increase of blood chloride levels and the incidence of major adverse kidney events within 30 days (MAKE30) in critically ill adults. Methods: We conducted a retrospective study to analyze the data of all adult patients admitted to the ICU of a tertiary academic hospital in China between April 2020 and April 2022. Patients were categorized based on their admission chloride levels (hyperchloremia ≥110 mmol/L and nonhyperchloremia <110 mmol/L) and stratified on the increased chloride levels 48 h after ICU admission (∆Cl ≥5 mmol/L and ∆Cl <5 mmol/L). The primary outcome was the MAKE30 incidence, including in-hospital death, new receipt of renal replacement therapy (RRT), and persistent renal dysfunction (PRD). Association between hyperchloremia at ICU admission and/or the increase of chloride and the incidence of MAKE30 were assessed using logistic regression. Result: A total of 2,024 patients with a median age of 67 years (interquartile range [IQR], 55-76 years) and a median Acute Physiology and Chronic Health Evaluation II score of 22 (IQR, 17-28) were included. Hyperchloremia occurred in 30.9% (n = 625), and ΔCl ≥5 mmol/L occurred in 18.5% (n = 375) of all ICU patients. The overall MAKE30 incidence was 33.6% (n = 680), including a 10.9% of 30-day hospital mortality (n = 220; as well as overall in-hospital mortality, 11.8% [n = 238]), a 20.2% (n = 408) of PRD, and a 18.0% (n = 365) of new RRT. After adjusted for confounders, it was found that ΔCl ≥5 mmol/L (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.096-1.93; P = 0.010), but not hyperchloremia (OR, 0.99; 95% CI, 0.77-1.28; P = 0.947), was associated with increased incidence of MAKE30. Conclusion: An increased chloride level in the first 48 h of ICU admission was an independent risk factor for MAKE30, whereas hyperchloremia at ICU admission was not associated with an increased incidence of MAKE30. Large-scale prospective studies are needed to verify our findings.</description><subject>Acute Kidney Injury</subject><subject>Adult</subject><subject>Aged</subject><subject>Chlorides</subject><subject>Critical Illness</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Kidney</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Water-Electrolyte Imbalance</subject><issn>1073-2322</issn><issn>1540-0514</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV9PwjAUxRujEUW_gTF99GV4224rfVzGlMoEs00MLy5jdAEdgisL8dvbCf6Jtw89aX_n9uYUoQsCHQKCX8f9QQf-FAWXHqAT4thggUPsQ6OBM4sySlvoVOsXw9hM8GPUYq7tONQlJ-hZDv0o8OIAyyH2--Eokj2jY-zF8ciXXhL08JNM-vjeuxtF2OuNg8jAA9kbBhMcjINhEn9ZI5lI3wvDCZZhiB-8RDZXZ-ioyEqtzvd7Gz3eBInft8LRbYNbOXOomdFRNi9yzgueAxFdo4AUBSVdNRPUsQslADLOaBfMIbgNClzQqRAuN4u10dWu77pavddKb9LlQueqLLM3tap1SrntMsEAGtTeoXm10rpSRbquFsus-kgJpE2yqUk2_Z-ssV3uX6inSzX7MX1H-dt3uyo3qtKvZb1VVTpXWbmZN_1M-F1qUaAMzCDmk0wx9glUhHh1</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Zhou, Dingxin</creator><creator>Jiang, Jun</creator><creator>Zhang, Jing</creator><creator>Cao, Fengsheng</creator><creator>Peng, Zhiyong</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20230301</creationdate><title>INCREASE IN CHLORIDE IS ASSOCIATED WITH MAJOR ADVERSE KIDNEY EVENTS IN CRITICALLY ILL PATIENTS</title><author>Zhou, Dingxin ; Jiang, Jun ; Zhang, Jing ; Cao, Fengsheng ; Peng, Zhiyong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3523-25e47fc77f7c0198c7701ff218ed9254fe900a73280f2106fc770792b99676763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Acute Kidney Injury</topic><topic>Adult</topic><topic>Aged</topic><topic>Chlorides</topic><topic>Critical Illness</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Kidney</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Water-Electrolyte Imbalance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Dingxin</creatorcontrib><creatorcontrib>Jiang, Jun</creatorcontrib><creatorcontrib>Zhang, Jing</creatorcontrib><creatorcontrib>Cao, Fengsheng</creatorcontrib><creatorcontrib>Peng, Zhiyong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Shock (Augusta, Ga.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Dingxin</au><au>Jiang, Jun</au><au>Zhang, Jing</au><au>Cao, Fengsheng</au><au>Peng, Zhiyong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>INCREASE IN CHLORIDE IS ASSOCIATED WITH MAJOR ADVERSE KIDNEY EVENTS IN CRITICALLY ILL PATIENTS</atitle><jtitle>Shock (Augusta, Ga.)</jtitle><addtitle>Shock</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>59</volume><issue>3</issue><spage>338</spage><epage>343</epage><pages>338-343</pages><issn>1073-2322</issn><eissn>1540-0514</eissn><abstract>Purpose: This study aimed to identify the association between hyperchloremia at intensive care unit (ICU) admission and/or the increase of blood chloride levels and the incidence of major adverse kidney events within 30 days (MAKE30) in critically ill adults. Methods: We conducted a retrospective study to analyze the data of all adult patients admitted to the ICU of a tertiary academic hospital in China between April 2020 and April 2022. Patients were categorized based on their admission chloride levels (hyperchloremia ≥110 mmol/L and nonhyperchloremia <110 mmol/L) and stratified on the increased chloride levels 48 h after ICU admission (∆Cl ≥5 mmol/L and ∆Cl <5 mmol/L). The primary outcome was the MAKE30 incidence, including in-hospital death, new receipt of renal replacement therapy (RRT), and persistent renal dysfunction (PRD). Association between hyperchloremia at ICU admission and/or the increase of chloride and the incidence of MAKE30 were assessed using logistic regression. Result: A total of 2,024 patients with a median age of 67 years (interquartile range [IQR], 55-76 years) and a median Acute Physiology and Chronic Health Evaluation II score of 22 (IQR, 17-28) were included. Hyperchloremia occurred in 30.9% (n = 625), and ΔCl ≥5 mmol/L occurred in 18.5% (n = 375) of all ICU patients. The overall MAKE30 incidence was 33.6% (n = 680), including a 10.9% of 30-day hospital mortality (n = 220; as well as overall in-hospital mortality, 11.8% [n = 238]), a 20.2% (n = 408) of PRD, and a 18.0% (n = 365) of new RRT. After adjusted for confounders, it was found that ΔCl ≥5 mmol/L (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.096-1.93; P = 0.010), but not hyperchloremia (OR, 0.99; 95% CI, 0.77-1.28; P = 0.947), was associated with increased incidence of MAKE30. Conclusion: An increased chloride level in the first 48 h of ICU admission was an independent risk factor for MAKE30, whereas hyperchloremia at ICU admission was not associated with an increased incidence of MAKE30. Large-scale prospective studies are needed to verify our findings.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>36455261</pmid><doi>10.1097/SHK.0000000000002062</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; EZB-FREE-00999 freely available EZB journals |
| subjects | Acute Kidney Injury Adult Aged Chlorides Critical Illness Hospital Mortality Humans Intensive Care Units Kidney Middle Aged Retrospective Studies Water-Electrolyte Imbalance |
| title | INCREASE IN CHLORIDE IS ASSOCIATED WITH MAJOR ADVERSE KIDNEY EVENTS IN CRITICALLY ILL PATIENTS |
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