title: Prevalence of acute kidney injury and prognostic significance in patients with acute myocarditis.
abstract: OBJECTIVE
  Myocarditis is an inflammation of the myocardium. The condition is commonly associated with rapid disease progression and often results in profound shock. Impaired renal function is the result of impairment in end-organ perfusion and is highly prevalent among critically ill patients. The aim of this study was to evaluate the incidence of acute kidney injury (AKI) and identify the relationship between AKI and the prognosis of patients with acute myocarditis.
  This retrospective study reviewed the medical records of 101 patients suffering from acute myocarditis between 1996 and 2011. Sixty of these patients (59%) developed AKI within 48 hours of being hospitalized. AKI defined as AKIN stage 3 (p = 0.007) and SOFA score (p = 0.03) were identified as predictors of in-hospital mortality in multivariate analysis. The conditional effect plot of the estimated risk against SOFA score upon admission categorized according to the AKIN stages showed that the risk of in-hospital mortality was highest among patients in AKIN stage 3 with a high SOFA score.
  
  
  CONCLUSIONS
  Among patients with acute myocarditis, AKI defined as AKIN stage 3 and elevated SOFA score were associated with unfavorable outcomes. AKIN classification is a simple, reproducible, and easily applied evaluation tool capable of providing objective information related to the clinical prognosis of patients with acute myocarditis.
authors.affiliation: Division of General Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ya-Wen
authors.initials: YW
authors.lastname: Yang
authors.forename: Che-Hsiung
authors.initials: CH
authors.lastname: Wu
authors.forename: Wen-Je
authors.initials: WJ
authors.lastname: Ko
authors.forename: Vin-Cent
authors.initials: VC
authors.lastname: Wu
authors.forename: Jin-Shing
authors.initials: JS
authors.lastname: Chen
authors.forename: Nai-Kuan
authors.initials: NK
authors.lastname: Chou
authors.forename: Hong-Shiee
authors.initials: HS
authors.lastname: Lai
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000453:epidemiology*; D000328:Adult; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009205:Myocarditis / Q000453:epidemiology*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult