Association Between the Central Venous Pressure and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury

Aifang Huang,1 Lin Liao,2 Ling Pan,1 Liao Pinhu3 1Renal Division, Department of Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China; 2Department of Clinical Laboratory, First Affiliated Hospital of Guangxi M...

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Autores principales:	Huang A, Liao L, Pan L, Pinhu L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	intensive care kidney disease 72h cvp value kaplan-meier curve cox regression analysis aki stage Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/fd7542334abe422499d0d14169e7bca8
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spelling	oai:doaj.org-article:fd7542334abe422499d0d14169e7bca82021-11-09T18:40:34ZAssociation Between the Central Venous Pressure and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury1178-7074https://doaj.org/article/fd7542334abe422499d0d14169e7bca82021-11-01T00:00:00Zhttps://www.dovepress.com/association-between-the-central-venous-pressure-and-all-cause-mortalit-peer-reviewed-fulltext-article-IJGMhttps://doaj.org/toc/1178-7074Aifang Huang,1 Lin Liao,2 Ling Pan,1 Liao Pinhu3 1Renal Division, Department of Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China; 2Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China; 3Department of Emergency, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of ChinaCorrespondence: Liao PinhuDepartment of Emergency, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, People’s Republic of ChinaTel +867712806099Email liaopinhu@163.comPurpose: Elevated central venous pressure (CVP) plays an important role in the occurrence of acute kidney injury (AKI) and it is also independently associated with the prognosis of critically ill patients. However, the effect of CVP on critically ill AKI patients remains unclear. In this study, we analyzed the relationship between CVP and all-cause mortality of critically ill patients with AKI.Patients and Methods: The clinical data of patients in intensive care unit (ICU) were retrieved from the Medical Information Mart for Intensive Care III (MIMIC-III) database and retrospectively analyzed. The all-cause mortality for up to 90 days was the main observed outcome. We used the minimum CVP value obtained during the first 72 hours after ICU admission for our analysis and patients were grouped according to this parameter. Patients were also analyzed after being further divided according to stages 1, 2 and 3 of AKI. Multiple Cox regression and Kaplan–Meier analyses were used to explore the association between CVP measurements and death of ICU patients with AKI.Results: A total of 1986 ICU patients with AKI were studied. A total of 527 (26.5%) patients died by day 90. The high CVP group (patients with ≥ 10 mmHg) had the lowest 90-day survival rate (P =0.001 by log rank test) when according to Kaplan–Meier analysis. By using Cox regression analysis, high CVP was found to be linked to an increase in mortality (CVP ≥ 10 mmHg versus ≤ 5 mmHg, HR, 1.336, 95% CI, 1.064 to 1.677, P trend=0.014). Furthermore, when using in a multivariate Cox regression analysis with CVP as a continuous variable, the higher CVP levels were still an independent risk factor for 90-day all-cause mortality (per 1 mmHg increase, HR, 1.031, 95% CI, 1.013– 1.049, P=0.001). In subgroup analysis, a similar trend was observed in patients with AKI stages 2 and 3.Conclusion: The minimum CVP level during the first 72h after ICU admission was positively associated with mortality in critically ill patients with AKI and this more marked in cases with severe AKI.Keywords: intensive care, kidney disease, 72h CVP value, Kaplan–Meier curve, Cox regression analysis, AKI stageHuang ALiao LPan LPinhu LDove Medical Pressarticleintensive carekidney disease72h cvp valuekaplan-meier curvecox regression analysisaki stageMedicine (General)R5-920ENInternational Journal of General Medicine, Vol Volume 14, Pp 8019-8027 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	intensive care kidney disease 72h cvp value kaplan-meier curve cox regression analysis aki stage Medicine (General) R5-920
spellingShingle	intensive care kidney disease 72h cvp value kaplan-meier curve cox regression analysis aki stage Medicine (General) R5-920 Huang A Liao L Pan L Pinhu L Association Between the Central Venous Pressure and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury
description	Aifang Huang,1 Lin Liao,2 Ling Pan,1 Liao Pinhu3 1Renal Division, Department of Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China; 2Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China; 3Department of Emergency, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of ChinaCorrespondence: Liao PinhuDepartment of Emergency, First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, People’s Republic of ChinaTel +867712806099Email liaopinhu@163.comPurpose: Elevated central venous pressure (CVP) plays an important role in the occurrence of acute kidney injury (AKI) and it is also independently associated with the prognosis of critically ill patients. However, the effect of CVP on critically ill AKI patients remains unclear. In this study, we analyzed the relationship between CVP and all-cause mortality of critically ill patients with AKI.Patients and Methods: The clinical data of patients in intensive care unit (ICU) were retrieved from the Medical Information Mart for Intensive Care III (MIMIC-III) database and retrospectively analyzed. The all-cause mortality for up to 90 days was the main observed outcome. We used the minimum CVP value obtained during the first 72 hours after ICU admission for our analysis and patients were grouped according to this parameter. Patients were also analyzed after being further divided according to stages 1, 2 and 3 of AKI. Multiple Cox regression and Kaplan–Meier analyses were used to explore the association between CVP measurements and death of ICU patients with AKI.Results: A total of 1986 ICU patients with AKI were studied. A total of 527 (26.5%) patients died by day 90. The high CVP group (patients with ≥ 10 mmHg) had the lowest 90-day survival rate (P =0.001 by log rank test) when according to Kaplan–Meier analysis. By using Cox regression analysis, high CVP was found to be linked to an increase in mortality (CVP ≥ 10 mmHg versus ≤ 5 mmHg, HR, 1.336, 95% CI, 1.064 to 1.677, P trend=0.014). Furthermore, when using in a multivariate Cox regression analysis with CVP as a continuous variable, the higher CVP levels were still an independent risk factor for 90-day all-cause mortality (per 1 mmHg increase, HR, 1.031, 95% CI, 1.013– 1.049, P=0.001). In subgroup analysis, a similar trend was observed in patients with AKI stages 2 and 3.Conclusion: The minimum CVP level during the first 72h after ICU admission was positively associated with mortality in critically ill patients with AKI and this more marked in cases with severe AKI.Keywords: intensive care, kidney disease, 72h CVP value, Kaplan–Meier curve, Cox regression analysis, AKI stage
format	article
author	Huang A Liao L Pan L Pinhu L
author_facet	Huang A Liao L Pan L Pinhu L
author_sort	Huang A
title	Association Between the Central Venous Pressure and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury
title_short	Association Between the Central Venous Pressure and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury
title_full	Association Between the Central Venous Pressure and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury
title_fullStr	Association Between the Central Venous Pressure and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury
title_full_unstemmed	Association Between the Central Venous Pressure and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury
title_sort	association between the central venous pressure and all-cause mortality in critically ill patients with acute kidney injury
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/fd7542334abe422499d0d14169e7bca8
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Association Between the Central Venous Pressure and All-Cause Mortality in Critically Ill Patients with Acute Kidney Injury

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