Impact of acute kidney injury (AKI) on metabolic compensation for respiratory acidosis in ICU patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)
Authors' conclusion
AKI leads to poor outcomes and compromises metabolic compensation of respiratory acidosis in ICU patients with AECOPD.
Study context
- Population
- ICU patients with AECOPD and need for respiratory support, January 2009 to December 2021
- Participants
- 498 patients
- Exposure
- AKI vs no AKI
- AKIn = 278
- Outcome
- Metabolic compensation of respiratory acidosis by AKI stage
Methodological detailsmixed model analysis with random intercept per patient
- Mixed model analysis with random intercept per patient
Main finding
As reported in the abstract
- Higher AKI stages: lower HCO3-/pCO2 ratios; expected HCO3- levels not reached
- Lower estimates for averaged change in HCO3- (per pCO2) with more severe AKI (mixed model)
Observational data: associations, not effects.
Further findings
30-day mortality
P = 0.001
Duration of mechanical ventilation
P = 0.001
Severity of hypercapnic acidosis (pH and pCO2)
pCO2 AKI 68.5 mmHg · No AKI 61.8 mmHg
Original publication
Impact of AKI on metabolic compensation for respiratory acidosis in ICU patients with AECOPD. J Crit Care. Published 26 June 2024. doi:10.
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