RESUMO
BACKGROUND: While acute kidney injury (AKI) alone is associated with increased mortality, the incidence of hospital admission with AKI among stable and exacerbating COPD patients and the effect of concurrent AKI at COPD exacerbation on mortality is not known. METHODS: A total of 189,561 individuals with COPD were identified from the Clinical Practice Research Datalink. Using Poisson and logistic regressions, we explored which factors predicted admission for AKI (identified in Hospital Episode Statistics) in this COPD cohort and concomitant AKI at a hospitalization for COPD exacerbation. Using survival analysis, we investigated the effect of concurrent AKI at exacerbation on mortality (n=36,107) and identified confounding factors. RESULTS: The incidence of AKI in the total COPD cohort was 128/100,000 person-years. The prevalence of concomitant AKI at exacerbation was 1.9%, and the mortality rate in patients with AKI at exacerbation was 521/1,000 person-years. Male sex, older age, and lower glomerular filtration rate predicted higher risk of AKI or death. There was a 1.80 fold (95% confidence interval: 1.61, 2.03) increase in adjusted mortality within the first 6 months post COPD exacerbation in patients suffering from AKI and COPD exacerbation compared to those who were AKI free. CONCLUSION: In comparison to previous studies on general populations and hospitalizations, the incidence and prevalence of AKI is relatively high in COPD patients. Coexisting AKI at exacerbation is prognostic of poor outcome.
Assuntos
Injúria Renal Aguda/etiologia , Injúria Renal Aguda/mortalidade , Progressão da Doença , Doença Pulmonar Obstrutiva Crônica/complicações , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Taxa de Filtração Glomerular , Hospitalização , Humanos , Incidência , Estimativa de Kaplan-Meier , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Reino UnidoRESUMO
Valence stabilization of polyvalent ions in gamma irradiated aqueous solutions is sometimes necessary in some chemical operations. In previous publications, valence stabilization of some polyvalent ions in solution upon gamma irradiation was achieved by using inorganic additives capable of interacting with the oxidizing or reducing species formed during water radiolysis. The results showed that the nature and duration of valence stabilization of Fe(II) depend on the concentration of the inorganic additives used. In the present work, a series of some organic additives has been used to investigate their capability in inducing valence stabilization of polyvalent iron ions, taken as an indicator, in aqueous acidic solutions when subjected to extended gamma irradiation. The results showed that the efficiency of valence stabilization depends on the amount and chemical structure of the organic additive used.
