Evidence map›Paper›PMID 27635668›Full record

ArticleAmerican journal of respiratory and critical care medicine2017

Recovery after Acute Kidney Injury.

John A Kellum, Florentina E Sileanu, Azra Bihorac, Eric A J Hoste, Lakhmir S Chawla

2 registry-linked trialsAbstract read
In one paragraph

Article in American journal of respiratory and critical care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 280 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
280citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06125184 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Effect of Vasopressin on Kidney and Cardiac Function in Previously Hypertensive Patients With Septic Shock: A Randomized Clinical Trial

TypeinterventionalSponsorPontificia Universidad Catolica de ChileRan2022 to 2025Enrolled50ConditionsKidney Injury, Acute, Cardiac Function FailedArmsVasopressor test
NCT07631221 recruitingnot on this mapstarted 2025, after this paper: background citation

Effect of Protein Dosage on Persistent Acute Renal Failure in Critically Ill Patients.

TypeobservationalSponsorHospital Italiano de Buenos AiresRan2025 to 2026Enrolled344ConditionsAcute Kidney Failure, Critical Illness, Protein Intake, Nutritional Support
3 · Its place in the literature

Who cites it

280 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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220 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

John A Kellum1 The Center for Critical Care Nephology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.ORCID 0000-0003-1995-2653
Florentina E Sileanu1 The Center for Critical Care Nephology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Azra Bihorac3 Department of Anesthesiology, University of Florida, Gainesville, Florida.
Eric A J Hoste4 Intensive Care Unit, Ghent University Hospital, Ghent, Belgium; and.
Lakhmir S Chawla5 Department of Medicine, Veterans Affairs Medical Center, Washington, DC.

Funding

PICS: A New Horizon for Surgical Critical CareP50GM111152 · NIGMS · UNIVERSITY OF FLORIDA · PI MOORE, FREDERICK A · 2014 to 2018
$10.7M
Integrating data, algorithms and clinical reasoning for surgical risk assessmentR01GM110240 · NIGMS · UNIVERSITY OF FLORIDA · PI BIHORAC, AZRA, RASHIDI, PARISA · 2016 to 2025
$5.1M
Biological Markers of Recovery for the KidneyR01DK070910 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KELLUM, JOHN A · 2006 to 2010
$1.8M
NIDDK NIH HHS R01 DK070910NIGMS NIH HHS P50 GM111152NIGMS NIH HHS R01 GM110240
6 · The paper itself

Abstract

rationaleLittle is known about how acute kidney injury (AKI) resolves, and whether patterns of reversal of renal dysfunction differ among patients with respect to ultimate recovery.

objectivesWe sought to examine different patterns for AKI reversal that are found in patients and assess how they relate to postdischarge outcomes.

methodsWe studied 16,968 critically ill patients with Kidney Disease Improving Global Outcomes stage 2 or 3 AKI, using an electronic database. Reversal of AKI was defined as alive and no longer meeting criteria for even stage 1. Recovery was defined as reversal at hospital discharge. MEASUREMENTS AND MAIN

resultsWe observed five patterns. The most common (4,508; 26.6%) was early reversal that was sustained through discharge, but almost as many patients (4,496; 26.5%) had no reversal at all. The remaining patients had late reversal after Day 7 (9.7%); early reversal with one or more relapses, but with ultimate recovery (22.5%); and relapsing without recovery (14.7%). Outcomes for patients with these phenotypes were quite different, with age-adjusted 1-year survival varying from more than 90% for early reversal to less than 40% for patients never reversing. Relapses are common (37.3%), especially in the first 72 hours after reversal, and are associated with a fivefold increased risk for death by 1 year compared with early sustained reversal.

conclusionsWe have identified five distinct recovery phenotypes on the basis of the clinical course over the first week after AKI manifestation. These phenotypes may identify patients amenable to therapeutic intervention. Long-term outcomes are associated with recovery status at hospital discharge.

Indexed as

Renal DialysisAcute Kidney InjuryAgedCritical IllnessFemaleHumansIntensive Care UnitsMaleMiddle AgedPatient DischargeRecurrenceRisk FactorsTreatment Outcomecritical caredialysisoutcomesrenal failuresurvival

Identifiers

PMID27635668
PMCPMC5363967

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.