Immune profiling of critically ill patients with acute kidney injury during the first week after various types of injuries: the REALAKI study
Authors' conclusion
Following various types of severe injuries, early AKI is associated with the initial inflammatory response. Presence of AKI at the end of the first week after injury is associated with injury-induced immunosuppression.
Study context
- Population
- Critically ill ICU patients after sepsis, trauma, surgery or burns; end-stage renal disease excluded
- Participants
- 359 patients · 3 ICUs
- Exposure
- Acute kidney injury (AKI) vs no AKI
- AKIn = 139
- Outcome
- Association between immune profiles and AKI (including persistent AKI) during the first week after admission
- Follow-up
- D1-2, D3-4, D5-7
Methodological detailsmulticentre (3 ICUs), multivariable logistic regression
- Multicentre (3 ICUs)
- Multivariable logistic regression
Main finding
As reported in the abstract
Immunological parameters independently associated with AKI (multivariable logistic regression)
AKI vs No AKIOdds ratio (CI)P value
D1-2; CD10lowCD16low immature neutrophils
3.03(1.7–5.5)
P < 0.001D5-7; increased IL-10 levels
1.38(1.12–1.71)
P = 0.001D5-7; ex vivo TNF-α production after LPS stimulation
0.51(0.27–0.91)
P = 0.03Observational data: associations, not effects.
Further findings
AKI incidence and persistence
- AKI at D1-2
- 139 (39%)
- AKI at D5-7
- 61 (20%)
- Persistent AKI at D5-7
- 94%
Recovery from AKI between D1-2 and D5-7 vs persistent AKI
- Patients who recovered tended to correct the immune alterations
Original publication
Immune profiling of critically ill patients with acute kidney injury during the first week after various types of injuries: the REALAKI study. Crit Care. Published 8 July 2024. doi:10.
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