Association of Active Renin Content With Mortality in Critically Ill Patients: A Post hoc Analysis of the Vitamin C, Thiamine, and Steroids in Sepsis (VICTAS) Trial*
Authors' conclusion
Baseline serum active renin levels were strongly associated with mortality in critically ill patients with sepsis. Furthermore, a greater relative activation in circulating renin from day 0 to day 3 was associated with a higher risk of death.
Study context
- Population
- Critically ill patients with sepsis (respiratory failure, septic shock, or both) enrolled in the VICTAS trial, 43 US hospitals95 day 3 samples
- Participants
- 103 patients
- Comparison
- High vs low baseline active renin
Methodological detailspost hoc analysis, multicentre
- Post hoc analysis
- Multicentre
Primary result
As reported in the abstract
30-day mortality by baseline active renin · 30 days
Hazard ratio (95% CI)P value
Above median vs Below medianmultivariable-adjusted
2.84(1.10–7.33)
P = 0.031Q2 vs Q1
2.01(0.37–11.04)
Q3 vs Q1
3.22(0.64–16.28)
Q4 vs Q1linear trend across quartiles
5.58(1.18–26.32)
P = 0.023for linear trendFurther findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Mortality, renin decreased vs increased from day 0 to day 3Improved survival when renin decreased | HR for mortality 0.22 (95% CI 0.08–0.60) | P = 0.003 | |
| Mortality per 1-SD (593.6 pg/mL) increase in renin from day 0 to day 3 | HR 3.75 (95% CI 1.94–7.22) | P < 0.001 | |
| 0.050.21520Ratio (log scale) |
30-day mortality by baseline active renin quartile
- p for linear trend = 0.023
Other renin-angiotensin system (RAS) components (Ang-(1-7), ACE2 activity, Ang-II, ACE activity)
- Did not show an association with mortality
VICTAS intervention × renin over the median (interaction)
- Mortality attenuated with VICTAS intervention in renin over the median on day 0
- p interaction 0.020
- Not attenuated on day 3
- p interaction 0.137
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Association of Active Renin Content With Mortality in Critically Ill Patients: A Post hoc Analysis of the Vitamin C, Thiamine, and Steroids in Sepsis (VICTAS) Trial*. Crit Care Med. Published 10 November 2023. doi:10.
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