ArticleCritical care (London, England)2024
Immune profiling of critically ill patients with acute kidney injury during the first week after various types of injuries: the REALAKI study.
Article in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- AKI as a systemic syndrome and its impact on other organ systems.Critical care (London, England) · 2026Review
- Influenza vaccination after advanced acute kidney injury: effects on mortality, cardiovascular events, and pneumonia-a target trial emulation.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- The effects of hemoadsorption in patients with sepsis-associated persistent severe AKI who require CRRT: A prospective, randomized controlled pilot study.Annals of intensive care · 2026Article
- Acute kidney injury and postoperative delirium.Journal of biomedical research · 2025Article
- Comparison of Hemodynamic Management by Hypotension Prediction Index or Goal-Directed Therapy in Radical Cystectomies: A Prospective Observational Study.Journal of clinical medicine · 2025Article
- Acute kidney injury: pathogenesis and therapeutic interventions.Molecular biomedicine · 2025Review
- Article
- Phellodendrine Exerts Protective Effects on Intra-abdominal Sepsis by Inactivating AKT/NF-kB Signaling.Cell biochemistry and biophysics · 2025Article
- Epidemiology and Outcomes of Bloodstream Infections in Patients in a Burns Intensive Care Unit: An 8-Year Retrospective Study.Open forum infectious diseases · 2025Article
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Abstract
backgroundAcute kidney injury (AKI) is common in hospitalized patients and results in significant morbidity and mortality. The objective of the study was to explore the systemic immune response of intensive care unit patients presenting with AKI, especially the association between immune profiles and persistent AKI during the first week after admission following various types of injuries (sepsis, trauma, surgery, and burns).
methodsREALAKI is an ancillary analysis of the REAnimation Low Immune Status Marker (REALISM) cohort study, in which 359 critically ill patients were enrolled in three different intensive care units. Patients with end-stage renal disease were excluded from the REALAKI study. Clinical samples and data were collected three times after admission: at day 1 or 2 (D1-2), day 3 or 4 (D3-4) and day 5, 6 or 7 (D5-7). Immune profiles were compared between patients presenting with or without AKI. Patients with AKI at both D1-2 and D5-7 were defined as persistent AKI. A multivariable logistic regression model was performed to determine the independent association between AKI and patients' immunological parameters.
resultsThree hundred and fifty-nine patients were included in this analysis. Among them, 137 (38%) were trauma patients, 103 (29%) post-surgery patients, 95 (26%) sepsis patients, and 24 (7%) were burn patients. One hundred and thirty-nine (39%) patients presented with AKI at D1-2 and 61 (20%) at D5-7. Overall, 94% presented with persistent AKI at D5-7. Patients with AKI presented with increased pro and anti-inflammatory cytokines and altered innate and adaptive immune responses. The modifications observed in the immune profiles tended to be more pronounced with increasing KDIGO stages. In the logistic regression model, a statistically significant association was observed at D1-2 between AKI and CD10
conclusionFollowing various types of severe injuries, early AKI is associated with the initial inflammatory response. Presence of AKI at the end of the first week after injury is associated with injury-induced immunosuppression.
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