Affiliation:
1. Guangzhou Medical University
2. Shenzhen Dymind Biotechnology Co., Ltd
3. Guangzhou Women and Children's Medical Center
Abstract
Abstract
Objective
Acute kidney injury (AKI) is a clinical syndrome that occurs as a result of a dramatic decline in kidney function caused by a variety of etiological factors. Its main biomarkers, serum creatinine and urine output, are not effective in diagnosing early AKI. For this reason, this study provides insight into this syndrome by exploring the comorbidities of AKI, which may facilitate the early diagnosis of AKI. In addition, organ crosstalk in AKI was systematically explored based on comorbidities to obtain clinically reliable results.
Methods
We collected data from the Medical Information Mart for Intensive Care-IV database on patients aged ≥ 18 years in intensive care units (ICU) who were diagnosed with AKI using the criteria proposed by Kidney Disease: Improving Global Outcomes. The Apriori algorithm was used to mine association rules on the diagnostic data of 55,486 AKI and non-AKI patients in the ICU. The comorbidities of AKI mined were validated through the Electronic Intensive Care Unit database, the Colombian Open Health Database, and medical literature, after which comorbidity results were visualized using a disease network. Finally, organ diseases were identified and classified from comorbidities to investigate renal crosstalk with other distant organs in AKI.
Results
We found 579 AKI comorbidities, and the main ones were disorders of lipoprotein metabolism, essential hypertension, and disorders of fluid, electrolyte, and acid-base balance. Of the 579 comorbidities, 554 were verifiable and 25 were new and not previously reported. In addition, crosstalk between the kidneys and distant non-kidney organs including the liver, heart, brain, lungs, and gut was observed in AKI with the strongest heart-kidney crosstalk, followed by lung-kidney crosstalk.
Conclusions
The comorbidities mined in this study using association rules are scientific and may be used for the early diagnosis of AKI and the construction of AKI predictive models. Furthermore, the organ crosstalk results obtained through comorbidities may provide supporting information for the management of short- and long-term treatment practices for organ dysfunction.
Publisher
Research Square Platform LLC
Reference42 articles.
1. Acute kidney injury and acute respiratory distress syndrome;Park BD;Crit Care Clin,2021
2. Acute kidney injury;Ronco C;Lancet,2019
3. Ostermann M, Bellomo R, Burdmann EA, Doi K, Endre ZH, Goldstein SL et al. Controversies in acute kidney injury: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference. Kidney Int. 2020;98:294–309.
4. Raising awareness of acute kidney injury: a global perspective of a silent killer;Lewington AJ;Kidney Int,2013
5. A long journey for acute kidney injury biomarkers;Oh DJ;Ren Fail,2020