Comorbidity phenotypes and the incidence and severity of acute kidney injury in older critically ill patients: a retrospective cohort study.
Atrial fibrillation/complex cardiac comorbidity phenotype linked to highest acute kidney injury risk in older ICU patients
Comorbidity phenotypes and the incidence and severity of acute kidney injury in older critically ill patients: a retrospective cohort study.
The impact of specific comorbidity combinations on the risk and severity of acute kidney injury (acute kidney injury) in older critically ill patients remains unclear.
This study aimed to identify comorbidity phenotypes using latent class analysis (latent class analysis) and quantify their associations with hospital-acquired acute kidney injury.
With baseline chronic kidney disease (chronic kidney disease) or early-onset acute kidney injury were excluded.
atrial fib with complex cardiac disease raises acute kidney injury risk most
Of 5,721 eligible patients, 2,202 (38.5%) developed hospital-acquired acute kidney injury.
Latent class analysis identified five phenotypes: Class 1 (Low Comorbidity), Class 2 (Respiratory & Nicotine), Class 3 (Isolated Metabolic & Atherosclerosis), Class 4 (Atrial Fibrillation & Complex Cardiac), and Class 5 (Ischemic Heart Failure).
Class 2 (HR 1.34) and Class 3 (HR 1.14) also had elevated risks.
Notably, secondary analysis revealed that Class 4 (OR 1.87) and Class 5 (OR 1.51) were strongly associated with progression to moderate-to-severe acute kidney injury, whereas Class 3 was not.
Distinct comorbidity phenotypes significantly influence the incidence and severity of hospital-acquired acute kidney injury.
Phenotypes characterized by Atrial Fibrillation and Ischemic Heart Failure represent the highest-risk groups for severe renal outcomes, highlighting the potential value of targeted renal surveillance and individualized hemodynamic management in older critically ill patients.