Hospitalized patients received furosemide undergoing acute kidney injury: the risk and prediction tool.
Hospitalized patients received furosemide undergoing acute kidney injury: the risk and prediction tool.
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DOI：
10.1186/s40001-023-01306-0
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发表时间：
2023-09-02
影响因子：
4.2
通讯作者：
Xu, Yan
中科院分区：
文献类型：
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作者：
Guan, Chen;Li, Chenyu;Xu, Lingyu;Che, Lin;Wang, Yanfei;Yang, Chengyu;Zhang, Ningxin;Liu, Zengying;Zhao, Long;Zhou, Bin;Man, Xiaofei;Luan, Hong;Xu, Yan
呋塞米是一种常用的利尿剂，用于治疗充血性心力衰竭和水肿，其诱导患者急性肾损伤（阿基）的潜在风险仍然是一个争论的话题。因此，本研究旨在检查接受呋塞米治疗的住院患者中医院获得性阿基（HA-AKI）的发生率，并调查与此结果相关的潜在风险因素。本研究包括22374例住院患者，这些患者从2012年6月1日至2017年12月31日接受或未接受呋塞米治疗。采用倾向评分匹配确定两组之间关于协变量的可比性。随后，构建诺模图来预测接受呋塞米治疗的患者发生阿基的概率。回归分析确定呋塞米的单日总剂量是阿基的最显著因素，其次是ICU给药、估计的肾小球滤过率、抗生素、他汀类药物、NSAID、β受体阻滞剂、质子泵抑制剂、慢性肾脏疾病和其他7个指标。亚组分析显示，呋塞米与外科手术、既往β受体阻滞剂、ACEI/ARB和抗生素治疗具有协同效应，导致联合使用时阿基风险增加。随后，开发了一个直观的预后列线图来预测呋塞米使用者中阿基的发生。通过校准分析评估诺模图的预测准确性，证明诺模图预测与阿基的实际可能性之间具有良好的一致性，概率为77.40%。在临床实践中使用呋塞米时，需要仔细考虑剂量、合并用药和患者肾功能等因素。我们的实用预后模型HA-AKI与呋塞米的使用可以用来帮助临床医生在病人的护理和治疗作出明智的决定。在线版本包含补充材料，可通过10.1186/s40001-023-01306- 0获得。宽度
Furosemide, a frequently prescribed diuretic for managing congestive heart failure and edema, remains a topic of debate regarding its potential risk of inducing acute kidney injury (AKI) in patients. Consequently, this study aims to examine the occurrence of hospital-acquired AKI (HA-AKI) in hospitalized patients who are administered furosemide and to investigate potential risk factors associated with this outcome. This study encompassed a cohort of 22374 hospitalized patients who either received furosemide treatment or not from June 1, 2012, to December 31, 2017. Propensity score matching was employed to establish comparability between the two groups regarding covariates. Subsequently, a nomogram was constructed to predict the probability of AKI occurrence among patients who underwent furosemide treatment. The regression analysis identified the single-day total dose of furosemide as the most significant factor for AKI, followed by ICU administration, estimated glomerular filtration rate, antibiotic, statin, NSAIDs, β-blockers, proton pump inhibitor, chronic kidney disease, and 7 other indicators. Subgroup analysis revealed a synergistic effect of furosemide with surgical operation, previous treatment with β-blockers, ACEI/ARB and antibiotics, leading to an increased risk of AKI when used in combination. Subsequently, a visually represented prognostic nomogram was developed to predict AKI occurrence in furosemide users. The predictive accuracy of the nomogram was assessed through calibration analyses, demonstrating an excellent agreement between the nomogram predictions and the actual likelihood of AKI, with a probability of 77.40%. Careful consideration of factors such as dosage, concurrent medication use, and renal function of the patient is necessary for clinical practice when using furosemide. Our practical prognostic model for HA-AKI associated with furosemide use can be utilized to assist clinicians in making informed decisions about patient care and treatment. The online version contains supplementary material available at 10.1186/s40001-023-01306-0.Width
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影响因子：
120.7
作者：
Chen, Horng H.;Anstrom, Kevin J.;Givertz, Michael M.;Stevenson, Lynne W.;Semigran, Marc J.;Goldsmith, Steven R.;Bart, Bradley A.;Bull, David A.;Stehlik, Josef;LeWinter, Martin M.;Konstam, Marvin A.;Huggins, Gordon S.;Rouleau, Jean L.;O'Meara, Eileen;Tang, W. H. Wilson;Starling, Randall C.;Butler, Javed;Deswal, Anita;Felker, G. Michael;O'Connor, Christopher M.;Bonita, Raphael E.;Margulies, Kenneth B.;Cappola, Thomas P.;Ofili, Elizabeth O.;Mann, Douglas L.;Davila-Roman, Victor G.;McNulty, Steven E.;Borlaug, Barry A.;Velazquez, Eric J.;Lee, Kerry L.;Shah, Monica R.;Hernandez, Adrian F.;Braunwald, Eugene;Redfield, Margaret M.
通讯作者：
Redfield, Margaret M.
影响因子：
--
作者：
Cui Y;Yang Y;Lei W;Lang X;Chen J
通讯作者：
Chen J
影响因子：
81.5
作者：
Kellum, John A.;Romagnani, Paola;Anders, Hans-Joachim
通讯作者：
Anders, Hans-Joachim
影响因子：
3
作者：
Kellum, JA
通讯作者：
Kellum, JA
袢利尿剂与成年患者院内获得性急性肾损伤风险增加相关：一项回顾性研究
影响因子：
3.9
作者：
通讯作者：
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