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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Wang, Danni Niu, Yue Chen, Dinghua Li, Chaofan Liu, Fei Feng, Zhe Cao, Xueying Zhang, Li Cai, Guangyan Chen, Xiangmei Li, Ping |
| Abstract | Background Nonmalignant pleural effusion (NMPE) is common and remains a definite health care problem. Pleural effusion was supposed to be a risk factor for acute kidney injury (AKI). Incidence of AKI in NMPE patients and whether there is correlation between the size of effusions and AKI is unknown. Objective To assess the incidence of AKI in NMPE inpatients and its association with effusion size. Study design and method We conducted a retrospective cohort study of inpatients admitted to the Chinese PLA General Hospital with pleural effusion from 2018-2021. All patients with pleural effusions confirmed by chest radiography (CT or X-ray) were included, excluding patients with diagnosis of malignancy, chronic dialysis, end-stage renal disease (ESRD), community-acquired AKI, hospital-acquired AKI before chest radiography, and fewer than two serum creatinine tests during hospitalization. Multivariate logistic regression and LASSO logistic regression models were used to identify risk factors associated with AKI. Subgroup analyses and interaction tests for effusion volume were performed adjusted for the variables selected by LASSO. Causal mediation analysis was used to estimate the mediating effect of heart failure, pneumonia, and eGFR < 60 ml/min/1.73m2 on AKI through effusion volume. Results NMPE was present in 7.8% of internal medicine inpatients. Of the 3047 patients included, 360 (11.8%) developed AKI during hospitalization. After adjustment by covariates selected by LASSO, moderate and large effusions increased the risk of AKI compared with small effusions (moderate: OR 1.47, 95%CI 1.11-1.94 p = 0.006; large: OR 1.86, 95%CI 1.05-3.20 p = 0.028). No significant modification effect was observed among age, gender, diabetes, bilateral effusions, and eGFR. Volume of effusions mediated 6.8% (p = 0.005), 4.0% (p = 0.046) and 4.6% (p < 0.001) of the effect of heart failure, pneumonia and low eGFR on the development of AKI respectively. Conclusion The incidence of AKI is high among NMPE patients. Moderate and large effusion volume is independently associated with AKI compared to small size. The effusion size acts as a mediator in heart failure, pneumonia, and eGFR. |
| Related Links | https://bmcnephrol.biomedcentral.com/counter/pdf/10.1186/s12882-024-03556-4.pdf |
| Ending Page | 10 |
| Page Count | 10 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712369 |
| DOI | 10.1186/s12882-024-03556-4 |
| Journal | BMC Nephrology |
| Issue Number | 1 |
| Volume Number | 25 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2024-04-01 |
| Access Restriction | Open |
| Subject Keyword | Nephrology Internal Medicine Nonmalignant pleural effusion Acute kidney injury Risk factor Prognosis |
| Content Type | Text |
| Resource Type | Article |
| Subject | Nephrology |
| Journal Impact Factor | 2.2/2023 |
| 5-Year Journal Impact Factor | 2.6/2023 |
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