ArticleJournal of nephrology2023
Kidney and lung crosstalk during critical illness: large-scale cohort study.
Article in Journal of nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 20 citations in OpenAlex.
- AKI as a systemic syndrome and its impact on other organ systems.Critical care (London, England) · 2026Review
- Kidney-organ interactions: recent advances and clinical implications.Current opinion in critical care · 2025Review
- Organ Crosstalk During Injury: Mechanisms of Lung-Kidney Interaction in Critical Illness.Comprehensive Physiology · 2025Review
- Nomogram risk prediction model for acute respiratory distress syndrome following acute kidney injury.Frontiers in medicine · 2025Article
- Temporal Relationship and Clinical Outcomes of Acute Kidney Injury Following Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis.Critical care explorations · 2024Review
- The Interaction of Acute Kidney Injury with Resuscitation Strategy in Sepsis: A Secondary Analysis of a Multicenter, Phase 3, Randomized Clinical Trial (CLOVERS).American journal of respiratory and critical care medicine · 2023Article
- Temporal validation of the MMCD score to predict kidney replacement therapy and in-hospital mortality in COVID-19 patients.BMC nephrology · 2023Observational
- Development of a predictive nomogram for acute respiratory distress syndrome in patients with acute pancreatitis complicated with acute kidney injury.Renal failure · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe relationship between the lung and kidney investigated in animal and clinical models has demonstrated substantial crosstalk. We aimed to evaluate the association between single vs. concurrent AKI and ARDS and its impact on patient outcomes. Secondly, we aimed to assess whether the order of appearance of these pathologies affected patient outcomes in patients with both diseases.
methodsThis single-center retrospective cohort study included adult patients admitted to the ICU from January 1, 2007 through May 1, 2018 (n = 76,988). Baseline characteristics and outcomes were compared among patients without ARDS or AKI and those with one or both ARDS and AKI. We also assessed outcomes across the order of appearance of these diseases among patients with both AKI and ARDS.
resultsWe enrolled 76,988 unique patients in the final analysis: 47,043 patients with neither AKI nor ARDS, 491 patients with ARDS alone, 27,928 patients with AKI alone, and 1,526 patients with both ARDS and AKI. Patients with both ARDS and AKI had higher ICU (21.2%) and hospital (28.4%) mortality compared to patients with ARDS alone (9.0% ICU mortality, 14.0% hospital mortality) or AKI alone (4.4% ICU mortality, 8.4% hospital mortality) (p < 0.001). These findings remained unchanged after adjusting for illness severity and comorbidities. Of the 1136 patients with both AKI and ARDS, 136 (12%) developed AKI first, 303 (27%) ARDS first, and 697 (61%) had simultaneous diseases. Patients who developed ARDS after AKI had significantly increased ICU (29.4%) and hospital (36.8%) mortality compared to patients who developed AKI after ARDS (13.9% ICU mortality, 21.5% hospital mortality) (p < 0.001).
conclusionsThe combination of AKI and ARDS leads to worse outcomes, including longer hospital and ICU lengths of stay, higher mortality, longer kidney replacement therapy, and longer ventilation requirements than in patients with AKI or ARDS alone. Among patients with both diagnoses, those who developed ARDS after AKI had the highest mortality.
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