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Acute kidney injury in patients with influenza A (H1N1) 2009

2011; Springer Science+Business Media; Volume: 37; Issue: 5 Linguagem: Inglês

10.1007/s00134-011-2166-8

1432-1238

Ville Pettilä, S. A. R. Webb, Michael Bailey, Belinda Howe, Ian Seppelt, Rinaldo Bellomo,

Influenza Virus Research Studies

We aim to evaluate the incidence and outcome of acute kidney injury (AKI) among critically ill adult patients with H1N1 2009 infection. From a prospectively collected influenza A (H1N1) 2009 bi-national, we identified 671 adult patients admitted to intensive care unit (ICU) from June 1 to August 31, 2009. Of these, 628 (93.6%) had admission and/or peak serum creatinine values during ICU stay. We defined AKI according to the creatinine criteria of the RIFLE classification. Of 628 adult patients, 211 [33.6%, 95% confidence interval (CI) 29.8–37.4%] had AKI: 41 (6.5%) risk, 56 (8.9%) injury and 114 (18.2%) failure. Of all 211 AKI patients, 76 [36.0% (29.4–42.6%)] died in hospital (36.6% in risk, 25.0% in injury and 41.3% in failure group) compared with 33 of 408 (8.1%) patients without AKI. Among the 33 AKI patients treated with renal replacement therapy, 13 died (39.4%). Mechanical ventilation [odds ratio (OR) 3.62 (2.07–6.34)], any severe co-morbidity (OR 2.36, 95% CI 1.15–3.71), age (OR 1.02, 95% CI 1.01–1.03 per 1 year increase), and AKI (OR 6.69, 95% CI 4.25–10.55) were independently associated with hospital mortality. Acute kidney injury appears common in H1N1 2009 infected patients and is independently associated with an increased risk of hospital mortality.