Journal of critical care · 2026
Acute respiratory distress syndrome and acute kidney injury in critically ill patients: A scoping review on this lung-kidney crosstalk.
СтатьяScoping ReviewПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Mattedi Francisco Z, Ribeiro Heitor S, Busatto Geraldo F, Carvalho Carlos R R, Zanetta Dirce Maria Trevisan, Burdmann Emmanuel A, HCFMUSP COVID-19 Study Group
Аннотация
INTRODUCTION: The incidence of acute kidney injury (AKI) in patients with acute respiratory distress syndrome (ARDS) is high; nonetheless, the lung-kidney crosstalk remains unclear.
OBJECTIVE: Describe the association between ARDS and AKI in critically ill patients.
METHODS: This scoping review was conducted according to the JBI and PRISM-ScR and included studies that investigated critically ill patients with ARDS (Participants), described AKI-related outcomes (Concept), and were conducted in hospitals (Context). MEDLINE, Embase, and LILACS databases were searched for articles published up to January 2024. Only observational studies were considered. Data on the diagnosis of ARDS-AKI and other kidney-related outcomes were extracted.
RESULTS: A total of 2943 studies were screened, of which 28 were included in this review. Most studies were prospective and the majority originated from Europe. AKI was diagnosed using the KDIGO criteria in most studies and the pooled overall rate of AKI development across the studies was 46.8% (95% CI: 40.8-52.8). Two reports identified ARDS as an independent risk factor for AKI. Kidney replacement therapy was described in 17 studies. AKI recovery was described in only three studies. Seventeen studies evaluated hospital mortality, specifically in patients with ARDS-AKI, and found a greater mortality risk as compared to only ARDS.
CONCLUSIONS: This scoping review emphasizes the variability of the evidence, which hinders definitive conclusions about the association between ARDS and AKI, despite their common occurrence in critically ill patients. Therefore, a significant gap remains in our understanding of this lung-kidney interaction.
OBJECTIVE: Describe the association between ARDS and AKI in critically ill patients.
METHODS: This scoping review was conducted according to the JBI and PRISM-ScR and included studies that investigated critically ill patients with ARDS (Participants), described AKI-related outcomes (Concept), and were conducted in hospitals (Context). MEDLINE, Embase, and LILACS databases were searched for articles published up to January 2024. Only observational studies were considered. Data on the diagnosis of ARDS-AKI and other kidney-related outcomes were extracted.
RESULTS: A total of 2943 studies were screened, of which 28 were included in this review. Most studies were prospective and the majority originated from Europe. AKI was diagnosed using the KDIGO criteria in most studies and the pooled overall rate of AKI development across the studies was 46.8% (95% CI: 40.8-52.8). Two reports identified ARDS as an independent risk factor for AKI. Kidney replacement therapy was described in 17 studies. AKI recovery was described in only three studies. Seventeen studies evaluated hospital mortality, specifically in patients with ARDS-AKI, and found a greater mortality risk as compared to only ARDS.
CONCLUSIONS: This scoping review emphasizes the variability of the evidence, which hinders definitive conclusions about the association between ARDS and AKI, despite their common occurrence in critically ill patients. Therefore, a significant gap remains in our understanding of this lung-kidney interaction.