title: Shock duration after resuscitation is associated with occurrence of post-cardiac arrest acute kidney injury.
abstract: This retrospective observational study investigated the clinical course and predisposing factors of acute kidney injury (AKI) developed after cardiac arrest and resuscitation. Eighty-two patients aged over 18 yr who survived more than 24 hr after cardiac arrest were divided into AKI and non-AKI groups according to the diagnostic criteria of the Kidney Disease/Improving Global Outcomes (KDIGO) Clinical Practice Guidelines for AKI. Among 82 patients resuscitated from cardiac arrest, AKI was developed in 66 (80.5%) patients (AKI group) leaving 16 (19.5%) patients in the non-AKI group. Nineteen (28.8%) patients of the AKI group had stage 3 AKI and 7 (10.6%) patients received renal replacement therapy during admission. The duration of shock developed within 24 hr after resuscitation was shorter in the non-AKI group than in the AKI group (OR 1.02, 95% CI 1.01-1.04, P < 0.05). On Multiple logistic regression analysis, the only predisposing factor of post-cardiac arrest AKI was the duration of shock. In conclusion, occurrence and severity of post-cardiac arrest AKI is associated with the duration of shock after resuscitation. Renal replacement therapy is required for patients with severe degree (stage 3) post-cardiac arrest AKI.
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Yong Won
authors.identifier: 0000-0003-0108-8932
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kyoung Chul
authors.identifier: 0000-0003-1818-2466
authors.initials: KC
authors.lastname: Cha
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Yong Sung
authors.identifier: 0000-0001-9897-4273
authors.initials: YS
authors.lastname: Cha
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Oh Hyun
authors.identifier: 0000-0002-8415-0318
authors.initials: OH
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Woo Jin
authors.identifier: 0000-0001-9368-0196
authors.initials: WJ
authors.lastname: Jung
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Tae Hoon
authors.identifier: 0000-0002-7683-7259
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Byoung Keun
authors.identifier: 0000-0002-3246-2993
authors.initials: BK
authors.lastname: Han
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Hyun
authors.identifier: 0000-0002-1696-9401
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Kang Hyun
authors.identifier: 0000-0001-9664-9186
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Eunhee
authors.identifier: 0000-0002-3449-0672
authors.initials: E
authors.lastname: Choi
authors.affiliation: Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Sung Oh
authors.identifier: 0000-0003-4585-3181
authors.initials: SO
authors.lastname: Hwang
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality* / Q000628:therapy*; D000368:Aged; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000401:mortality; D056910:Republic of Korea / Q000453:epidemiology; D012151:Resuscitation / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012769:Shock / Q000401:mortality*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Acute Kidney Injury; Cardiac Arrest; Heart Arrest; Post-cardiac Arrest Syndrome; Renal Failure; Renal Replacement Therapy; Resuscitation