title: Acute kidney injury in critically ill patients with lung disease: kidney-lung crosstalk.
abstract: OBJECTIVE
  To examine the factors associated with acute kidney injury and outcome in patients with lung disease.
  
  
  METHODS
  A prospective study was conducted with 100 consecutive patients admitted to a respiratory intensive care unit in Fortaleza (CE), Brazil. The risk factors for acute kidney injury and mortality were investigated in a group of patients with lung diseases.
  
  
  RESULTS
  The mean age of the study population was 57 years, and 50% were male. The incidence of acute kidney injury was higher in patients with PaO2/FiO2<200 mmHg (54% versus 23.7%; p=0.02). Death was observed in 40 cases and the rate of mortality of the acute kidney injury group was higher (62.8% versus 27.6%; p=0.01). The independent factor that was found to be associated with acute kidney injury was PaO2/FiO2<200 mmHg (p=0.01), and the independent risk factors for death were PEEP at admission (OR: 3.6; 95%CI: 1.3-9.6; p=0.009) and need for hemodialysis (OR: 7.9; 95%CI: 2.2-28.3; p=0.001).
  
  
  CONCLUSIONS
  There was a higher mortality rate in the acute kidney injury group. Increased mortality was associated with mechanical ventilation, high PEEP, urea and need for dialysis. Further studies must be performed to better establish the relationship between kidney and lung injury and its impact on patient outcome.
authors.affiliation: Department of Internal Medicine, Faculdade de Medicina, Universidade Federal do Ceará - UFC - Fortaleza CE, Brazil.
authors.forename: Krasnalhia Lívia Soares
authors.initials: KL
authors.lastname: de Abreu
authors.forename: Geraldo Bezerra
authors.initials: GB
authors.lastname: da Silva Junior
authors.forename: Thalita Diógenes
authors.initials: TD
authors.lastname: Muniz
authors.forename: Adller Gonçalves Costa
authors.initials: AG
authors.lastname: Barreto
authors.forename: Rafael Siqueira Athayde
authors.initials: RS
authors.lastname: Lima
authors.forename: Marcelo Alcântara
authors.initials: MA
authors.lastname: Holanda
authors.forename: Eanes Delgado Barros
authors.initials: ED
authors.lastname: Pereira
authors.forename: Alexandre Braga
authors.initials: AB
authors.lastname: Libório
authors.forename: Elizabeth de Francesco
authors.initials: Ede F
authors.lastname: Daher
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D001938:Brazil; D016638:Critical Illness; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008171:Lung Diseases / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration / Q000706:statistics & numerical data; D011446:Prospective Studies; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012307:Risk Factors
chemical_list: D010100:Oxygen
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