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1. Incidence and Outcome of Subclinical Acute Kidney Injury Using penKid in Critically Ill Patients

Author

Isabelle Rennuit, Matthieu Legrand, Oliver Hartmann, Bernard Cholley, Etienne Gayat, Antoine Vieillard-Baron, François Dépret, Philippe Montravers, Qin Lu, Marie-Céline Fournier, Nicolas Deye, Nicolas Bréchot, Michael Darmon, Sebastien Pili-Floury, Bertrand Guidet, Jacques Duranteau, Alexandre Mebazaa, Marc Leone, Romain Sonneville, Alain Cariou, Samir Jaber, Charles Damoisel, Pierre-François Laterre, Alexa Hollinger, Xavier Monnet, Jean-Yves Lefrant, Haikel Oueslati, Joachim Struck, Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Lariboisière-Fernand-Widal [APHP], Hôpital Ambroise Paré [AP-HP], Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Beaujon, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Service Anesthésie et Réanimation [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Microcirculation, bioénergétique, inflammation et insuffisance circulatoire aiguë (URCT), Université Paris 13 (UP13)-Université Paris-Sud - Paris 11 (UP11)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Cliniques Universitaires Saint-Luc [Bruxelles], Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Service d'Anesthésie-Réanimation [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Service de Réanimation Médicale [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Paris-Sud - Paris 11 (UP11)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC), Service de médecine chirurgicale intensive [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Critical Illness, Decision Making, Renal function, urologic and male genital diseases, Critical Care and Intensive Care Medicine, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, penKid, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, renal recovery, Risk Factors, Internal medicine, Clinical endpoint, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Protein Precursors, Subclinical infection, Aged, Creatinine, business.industry, Incidence (epidemiology), Incidence, Hazard ratio, Acute kidney injury, Enkephalins, Acute Kidney Injury, Middle Aged, medicine.disease, female genital diseases and pregnancy complications, Confidence interval, 3. Good health, Europe, 030228 respiratory system, chemistry, biomarker, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, business, proenkephalin, Biomarkers
Abstract

International audience; Rationale: Subclinical acute kidney injury (sub-AKI) refers to patients with low serum creatinine but elevated alternative biomarkers of AKI. Its incidence and outcome in critically ill patients remain, however, largely unknown. Plasma proenkephalin A 119–159 (penKid) has been proposed as a sensitive biomarker of glomerular function.Objectives: In this ancillary study of two cohorts, we explored the incidence and outcome of sub-AKI based on penKid.Methods: A prospective observational study in ICUs was conducted. FROG-ICU (French and European Outcome Registry in ICUs) enrolled 2,087 critically ill patients, and AdrenOSS-1 (Adrenomedullin and Outcome in Severe Sepsis and Septic Shock-1) enrolled 583 septic patients. The primary endpoint was 28-day mortality after ICU admission. Sub-AKI was defined by an admission penKid concentration above the normal range (i.e., >80 pmol/L) in patients not meeting the definition of AKI. A sensitivity analysis was performed among patients with estimated glomerular filtration rate above 60 ml/min/1.73 m2 at ICU admission.Measurements and Main Results: In total, 6.1% (122/2,004) and 6.7% (39/583) of patients from the FROG-ICU and AdrenOSS-1 cohorts met the definition of sub-AKI (11.6% and 17.5% of patients without AKI). In patients without AKI or with high estimated glomerular filtration rate, penKid was associated with higher mortality (adjusted standardized hazard ratio [HR], 1.4 [95% confidence interval, 1.1–1.8]; P = 0.010; and HR, 1.6 [95% confidence interval, 1.3–1.8]; P

Published
2020
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2. Modulation by Polymyxin-B Hemoperfusion of Inflammatory Response Related to Severe Peritonitis

Author

Stéphanie Chevalier, Martine Ferrandière, Matthieu Jabaudon, Thomas Kerforne, Carlos Vela, Laurent Martin-Lefevre, Antoine Dewitte, Eric Kipnis, Olivier Collange, Anne-Claire Lukaszewicz, Rémi Coudroy, Didier Payen, Benoit Veber, Jean-Claude Lecron, Mahmoud Kaaki, Jihad Mallat, René Robert, Sandrine Charreau, Yoann Launey, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Department of anesthesiology and intensive care, Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Department of anesthesiology and critical care medicine, Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Alloimmunité-Autoimmunité-Transplantation (A2T), Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Service d'Anesthésie et Soins Intensifs, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Microcirculation, bioénergétique, inflammation et insuffisance circulatoire aiguë (URCT), Université Paris-Sud - Paris 11 (UP11)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC), Service de réanimation médicale [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Services de soins intensifs, CHU Strasbourg, Département d'Anesthésie et Réanimation Chirurgicale [Poitiers], Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques ( IRTOMIT), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université Lille 2 - Faculté de Médecine, Laboratoire Inflammation, Tissus épithéliaux et Cytokines (LITEC), Université de Poitiers, Institut Français de Recherche pour l'Exploitation de la Mer - Brest (IFREMER Centre de Bretagne), Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER), Université Paris 13 (UP13)-Université Paris-Sud - Paris 11 (UP11)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Faculté de Médecine Henri Warembourg - Université de Lille, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Poitiers

Subjects
Male, 0301 basic medicine, medicine.medical_specialty, medicine.medical_treatment, Population, Peritonitis, [SDV.CAN]Life Sciences [q-bio]/Cancer, Critical Care and Intensive Care Medicine, Systemic inflammation, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, education, Aged, Polymyxin B, education.field_of_study, Interleukin-6, Tumor Necrosis Factor-alpha, Septic shock, business.industry, Standard treatment, Interleukin-17, 030208 emergency & critical care medicine, Middle Aged, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, medicine.disease, Hemoperfusion, Shock, Septic, Interleukin-10, 3. Good health, 030104 developmental biology, Cytokine, Emergency Medicine, Female, medicine.symptom, business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, medicine.drug
Abstract

International audience; Conflicting results have been reported on the influence of Polymyxin-B hemoperfusion treatment on systemic inflammation markers. The aim of the study was to assess in a randomized control trial the influence on plasma cytokine concentrations of Polymyxin-B hemoperfusion in septic shock due to peritonitis. A panel of 10 pro- or anti-inflammatory cytokines was measured in 213 patients with peritonitis-induced septic shock enrolled in the randomized trial ABDOMIX testing the impact of 2 Polymyxin-B hemoperfusion sessions with standard treatment. Gram-negative bacteria were identified in 69% of patients. In the overall population, baseline plasma cytokine concentrations were not different between the two groups. Circulating tumor necrosis factor-α, interleukin (IL)-1β, IL-10, IL-6, and IL-1RA decreased significantly over time in both groups (P

Published
2017
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3. Association between systemic hemodynamics and septic acute kidney injury in critically ill patients: a retrospective observational study

Author

Didier Payen, Etienne Gayat, Anne Claire Lukaszewicz, Christelle Simon, Joaquim Mateo, Matthieu Legrand, Claire Dupuis, BMC, Ed., Service d'Anesthésie et Soins Intensifs, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Microcirculation, bioénergétique, inflammation et insuffisance circulatoire aiguë (URCT), Université Paris 13 (UP13)-Université Paris-Sud - Paris 11 (UP11)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Biostatistique et épidemiologie clinique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Alloimmunité-Autoimmunité-Transplantation (A2T), Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris-Sud - Paris 11 (UP11)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)

Subjects
Male, Kidney Disease, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Hemodynamics, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, urologic and male genital diseases, Medical and Health Sciences, 0302 clinical medicine, 80 and over, Medicine, Simplified Acute Physiology Score, Aged, 80 and over, Acute kidney injury, Central venous pressure, Shock, Hematology, Middle Aged, Acute Kidney Injury, Shock, Septic, female genital diseases and pregnancy complications, 3. Good health, Survival Rate, Intensive Care Units, SAPS II, Shock (circulatory), Cardiology, Female, medicine.symptom, medicine.medical_specialty, Mean arterial pressure, Renal and urogenital, Sepsis, 03 medical and health sciences, Clinical Research, Internal medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, Intensive care medicine, Retrospective Studies, Aged, business.industry, Septic, urogenital system, 030208 emergency & critical care medicine, Length of Stay, medicine.disease, Emergency & Critical Care Medicine, Injury (total) Accidents/Adverse Effects, Commentary, business
Abstract

International audience; INTRODUCTION: The role of systemic hemodynamics in the pathogenesis of septic acute kidney injury (AKI) has received little attention. The purpose of this study was to investigate the association between systemic hemodynamics and new or persistent of AKI in severe sepsis. METHODS: A retrospective study between 2006 and 2010 was performed in a surgical ICU in a teaching hospital. AKI was defined as development (new AKI) or persistent AKI during the five days following admission based on the Acute Kidney Injury Network (AKIN) criteria. We studied the association between the following hemodynamic targets within 24 hours of admission and AKI: central venous pressure (CVP), cardiac output (CO), mean arterial pressure (MAP), diastolic arterial pressure (DAP), central venous oxygen saturation (ScvO2) or mixed venous oxygen saturation (SvO2). RESULTS: This study included 137 ICU septic patients. Of these, 69 had new or persistent AKI. AKI patients had a higher Simplified Acute Physiology Score (SAPS II) (57 (46 to 67) vs. 45 (33 to 52), P

Published
2013
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