Evidence map›Paper›PMID 39362971›Full record

ArticleScientific reports2024

Acute kidney injury developed in the intensive care unit: a population-based prospective cohort study in the Brazilian Amazon.

Fernando A F Melo, Emmanuel A Burdmann, Etienne Macedo, Ravindra Mehta, Dirce M T Zanetta

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Article in Scientific reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

5 authors.

Fernando A F MeloDivision of Urology, Acre Federal University, Rio Branco, Acre, Brazil.
Emmanuel A BurdmannLaboratório de Investigação (LIM) 12, Serviço de Nefrologia, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil.
Etienne MacedoDepartment of Medicine, University of California San Diego (UCSD), San Diego, CA, USA.
Ravindra MehtaDepartment of Medicine, University of California San Diego (UCSD), San Diego, CA, USA.
Dirce M T ZanettaDepartment of Epidemiology, School of Public Health, University of São Paulo, São Paulo, São Paulo, Brazil. dzanetta@usp.br.

Funding

Conselho Nacional de Desenvolvimento Científico e Tecnológico 304743/2017-8Fundação de Amparo à Pesquisa do Estado de São Paulo 2014/19286-4
6 · The paper itself

Abstract

The Brazilian Amazon is a vast area with limited health care resources. To assess the epidemiology of critically ill acute kidney injury (AKI) patients in this area, a prospective cohort study of 1029 adult patients of the three intensive care units (ICUs) of Rio Branco city, the capital of Acre state, were evaluated from February 2014 to February 2016. The incidence of AKI was 53.3%. Risk factors for AKI included higher age, nonsurgical patients, admission to the ICU from the ward, higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores at ICU admission, and positive fluid balance > 1500 ml/24 hours in the days before AKI development in the ICU, with aOR of 1.3 (95% CI 1.03-1.23), 1.47 (95% CI 1.07-2.03), 1.96 (95% CI 1.40-2.74), 1.05 (95% CI 1.03-1.08) for each unit increase, and 1.62 (95% CI 1.16-2.26), respectively. AKI was associated with higher ICU mortality (aOR 2.03, 95% CI 1.29-3.18). AKI mortality was independently associated with higher age, nonsurgical patients, sepsis at ICU admission, presence of shock or use of vasoactive drugs, mechanical ventilation and mean positive fluid balance in the ICU > 1500 ml/24 hours, both during ICU follow-up, with aOR 1.27 (95% CI 1.14-1.43) for each 10-year increase, 1.64 (95% CI 1.07-2.52), 2.35 (95% CI 1.14-4.83), 1.88 (95% CI 1.03-3.44), 6.73 (95% CI 4.08-11.09), 2.31 (95% CI 1.52-3.53), respectively. Adjusted hazard ratios for AKI mortality 30 and 31-180 days after ICU discharge were 3.13 (95% CI 1.84-5.31) and 1.69 (95% CI 0.99-2.90), respectively. AKI incidence was strikingly high among critically ill patients in the Brazilian Amazon. The AKI etiology, risk factors and outcomes were similar to those described in high-income countries, but mortality rates were higher.

Indexed as

Acute Kidney InjuryIntensive Care UnitsAdultAgedAPACHEBrazilCritical IllnessFemaleHospital MortalityHumansIncidenceMaleMiddle AgedProspective StudiesRisk FactorsAcute kidney injuryAmazonCritically ill patientsDisadvantaged populationsEpidemiologyLow-income and middle-income countries

Identifiers

PMID39362971
PMCPMC11452208

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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.