Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan,
Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan.
Blood Purif. 2024;53(8):641-649. doi: 10.1159/000539808. Epub 2024 Jun 13.
Tachycardia caused by sympathetic overactivity impairs myocardial function and raises septic patients' mortality. This study examined whether tachycardia is associated with acute kidney injury (AKI) period-prevalence among critically ill patients with and without sepsis.
In 328 patients (119 sepsis and 209 non-sepsis) admitted to our intensive care unit (ICU), we assessed heart rate at ICU admission, plasma neutrophil gelatinase-associated lipocalin (NGAL) and N-terminal pro-B-type natriuretic peptide, and urinary L-type fatty acid-binding protein and N-acetyl-β-
Tachycardia was independently correlated with AKI prevalence during the first week after ICU admission in the septic patients, but not in the non-septic patients. A dose-dependent increase in AKI period-prevalence was observed across ascending heart rate ranges. Furthermore, we discovered a dose-dependent increase in renal biomarker-positive patients regarding plasma NGAL and urinary NAG over increasing heart rate ranges 48 h after admission.
The findings revealed an independent relationship between tachycardia and AKI prevalence during the first week of ICU in septic patients. Heart rate was found to have a dose-dependent effect on AKI prevalence and renal insult monitored by biomarkers.
交感神经过度活跃引起的心动过速会损害心肌功能，并增加脓毒症患者的死亡率。本研究旨在探讨心动过速是否与重症监护病房（ICU）中伴有和不伴有脓毒症的危重症患者的急性肾损伤（AKI）发病期患病率相关。
在入住 ICU 的 328 名患者（119 名脓毒症和 209 名非脓毒症）中，我们评估了 ICU 入院时的心率、入院后 0 和 48 小时的血浆中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和 N 末端 pro-B 型利钠肽，以及尿液 L 型脂肪酸结合蛋白和 N-乙酰-β-
在脓毒症患者中，心动过速与 ICU 入院后第一周的 AKI 患病率独立相关，但在非脓毒症患者中无此相关性。随着心率范围的升高，AKI 发病期患病率呈递增趋势。此外，我们发现随着入院后 48 小时心率范围的升高，血浆 NGAL 和尿液 NAG 中肾生物标志物阳性患者的 AKI 患病率呈剂量依赖性增加。
研究结果表明，在脓毒症患者 ICU 入住第一周，心动过速与 AKI 患病率之间存在独立关系。心率与 AKI 患病率和生物标志物监测的肾损伤呈剂量依赖性关系。
