Abstract Number: PB2328
Meeting: ISTH 2020 Congress
Background: Acute kidney injury (AKI) is a complication of acute medico-surgical diseases, increasing the risk for chronic kidney insufficiency. We recently found that AKI was found in one in three patients with pulmonary embolism (PE), and associated with an increased risk of death and bleeding. Evolution of renal function in patients with AKI and PE is unknown.
Aims: To report the proportion of PE patients with AKI who recover a normal renal function, after PE.
Methods: We performed a post-hoc analysis of patients included in one prospective monocentric registry, from September 2013 to October 2018. Population study corresponded to all adult patients with symptomatic PE, in whom AKI (according to KDIGO guidelines) was present at the time of PE and at least one Serum Creatinine value assessment during the follow-up . The primary outcome was the proportion of patients who recover from AKI. We determined final recovery status as disappearance of AKI criteria during follow-up (any creatinine assessment during the follow-up).
Secondary outcomes were timing of recovery, and characteristics associated with AKI recovery during follow-up, in univariable and multivariable analysis.
Results: Among the 270 patients with acute pulmonary embolism, 41 (15.19%, 95%CI [11.12-20.03]) had AKI at baseline. Recovery occurred in 30 patients (73%, 95%CI [57-86]), during the first week in 24 patients. Baseline characteristics and AKI evolution are presented in table 1. In univariate analysis, presence of cancer was associated with absence of recovery. No item was found to be associated with recovery in multivariate analysis.
|AKI baseline (n=41)||Recovery (n=30)||Non Recovery (n=11)||p value|
|Female gender (%)||23 (56,1)||19 (63,3)||4 (36,36)||0,16|
|Age (mean ± Sd)||78,05 ± 8,38||77,7 ± 9,07||79 ± 6,41||>0.2|
|Stage of AKI at admission : 1/2/3||35/4/2||26/3/1||9/1/1||>0.2|
|Chronic heart failure||4||3||1||>0.2|
|Chronic lung disease||4||4||0||>0.2|
|sPESI : 0 / ≥ 1||8/33||5/25||3/8||>0.2|
|CT scan diagnosis||22||19||3||0,056|
|Time of recovery: < 2 days / [2 - 7[ days / [7 - 90[ days /> 90 days||12 / 12 / 5 / 1|
[Table 1: Evolution of renal dysfunction according to baseline characteristics]
Conclusions: In PE patients with AKI, renal recovery is frequent (73% (95%CI [57-86]) and rapid (7 first days). However, about a quarter of patients did not fully recover, at least 90 days after PE. Further research are needed to develop prophylactic strategies improving the recovery rate.
To cite this abstract in AMA style:Murgier M, Fouillet L, Ollier E, Merah A, Moulin N, Accassat S, Duvillard C, De Magalhaes E, Mismetti P, Monreal M, Bertoletti L. Recovery from Acute Kidney Injury in Patients with Pulmonary Embolism: A Monocenter Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/recovery-from-acute-kidney-injury-in-patients-with-pulmonary-embolism-a-monocenter-study/. Accessed November 30, 2021.
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