Effect of probiotics on the incidence of acute kidney injury in patients with severe pneumonia.

OBJECTIVE

This study employed a retrospective analysis to investigate whether probiotics were associated with a lower incidence of Acute Kidney Injury (AKI) in patients with severe pneumonia.

METHODS

We retrospectively analyzed patients with severe pneumonia who required mechanical ventilation and had no prior history of kidney disease.

RESULTS

Based on the inclusion and exclusion criteria, a total of 267 cases were included, comprising 190 patients who did not develop AKI and 77 patients who developed AKI. Statistically significant differences ( < 0.05) were observed between the AKI and non-AKI groups in terms of gender, CRP, PCT, PLT, SOFA score, ALB, Cr, and BUN. The proportion of probiotics use was lower in the AKI group, with a statistically significant difference between the two groups ( < 0.05). Using the occurrence of AKI as the dependent variable, a multivariate logistic regression analysis was performed including gender, CRP, PCT, PLT, SOFA score, ALB, Cr, and BUN. The analysis demonstrated that probiotics were associated with a lower incidence of AKI during ICU hospitalization in patients with severe pneumonia ( = 0.031). The results of the ordered logistic regression further indicated that probiotics use reduced the incidence of AKI (Coefficient = -0.7748,  = 0.006). Subgroup analysis revealed that probiotics were associated with a lower incidence of stage 1 AKI (OR: 0.4023, 95% CI: 0.1895-0.8540,  = 0.018) but not stage 2 (OR: 0.683, 95% CI: 0.2083-2.242,  = 0.53) or stage 3 AKI (OR: 0.9007, 95% CI: 0.2851-2.845,  = 0.859). Among the 146 patients in the probiotic group and 121 patients in the non-probiotic group, 44 patients developed stage 1 AKI, 15 developed stage 2 AKI, and 18 developed stage 3 AKI. Creatinine was selected for matching to balance the confounder. After propensity score matching, a total of 224 cases were matched (112 in each group). The incidence of stage 1 AKI ( = 0.019) remained statistically significant, while no significant differences were observed in the incidence of stage 2 AKI ( = 0.757) or stage 3 AKI ( = 0.757) between the two groups.

CONCLUSION

Probiotics were associated with a lower incidence of stage 1 AKI in patients with severe pneumonia. However, our research was a single-center retrospective study, and multi-center randomized controlled studies would be needed in the future for validation.