Skip to main content Accessibility help
×
Home
Hostname: page-component-59b7f5684b-s82fj Total loading time: 0.294 Render date: 2022-09-28T00:59:15.719Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "displayNetworkTab": true, "displayNetworkMapGraph": false, "useSa": true } hasContentIssue true

Associations between early thiamine administration and clinical outcomes in critically ill patients with acute kidney injury

Published online by Cambridge University Press:  16 August 2021

Xunliang Li
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Hong Luan
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Hui Zhang
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Chenyu Li
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Quandong Bu
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Bin Zhou
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Nina Tang
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Haiyan Zhou
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Yan Xu
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Wei Jiang
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Long Zhao
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Xiaofei Man
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Lin Che
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Yanfei Wang
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Congjuan Luo
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
Jianping Sun*
Affiliation:
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
*
*Corresponding author: Dr Jianping Sun, email sjpqd@163.com

Abstract

The effects of early thiamine use on clinical outcomes in critically ill patients with acute kidney injury (AKI) are unclear. The purpose of this study was to investigate the associations between early thiamine administration and clinical outcomes in critically ill patients with AKI. The data of critically ill patients with AKI within 48 h after ICU admission were extracted from the Medical Information Mart for Intensive Care III (MIMIC III) database. PSM was used to match patients early receiving thiamine treatment to those not early receiving thiamine treatment. The association between early thiamine use and in-hospital mortality due to AKI was determined using a logistic regression model. A total of 15 066 AKI patients were eligible for study inclusion. After propensity score matching (PSM), 734 pairs of patients who did and did not receive thiamine treatment in the early stage were established. Early thiamine use was associated with lower in-hospital mortality (OR 0·65; 95 % CI 0·49, 0·87; P < 0·001) and 90-d mortality (OR 0·58; 95 % CI 0·45, 0·74; P < 0·001), and it was also associated with the recovery of renal function (OR 1·26; 95 % CI 1·17, 1·36; P < 0·001). In the subgroup analysis, early thiamine administration was associated with lower in-hospital mortality in patients with stages 1 to 2 AKI. Early thiamine use was associated with improved short-term survival in critically ill patients with AKI. It was possible beneficial role in patients with stages 1 to 2 AKI according to the Kidney Disease: Improving Global Outcomes criteria.

Type
Research Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

These authors contributed equally to this work

References

Hoste, E, Clermont, G, Kersten, A, et al. (2006) RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care 10, R73.CrossRefGoogle ScholarPubMed
Doi, K & Rabb, H (2016) Impact of acute kidney injury on distant organ function: recent findings and potential therapeutic targets. Kidney Int 89, 555564.CrossRefGoogle ScholarPubMed
Al-Jaghbeer, M, Dealmeida, D, Bilderback, A, et al. (2018) Clinical decision support for in-hospital AKI. J Am Soc Nephrol: JASN 29, 654660.CrossRefGoogle ScholarPubMed
Hoste, E, Bagshaw, S, Bellomo, R, et al. (2015) Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med 41, 14111423.CrossRefGoogle ScholarPubMed
Woolum, J, Abner, E, Kelly, A, et al. (2018) Effect of thiamine administration on lactate clearance and mortality in patients with septic shock. Crit Care Med 46, 17471752.CrossRefGoogle ScholarPubMed
Ostermann, M, Summers, J, Lei, K, et al. (2020) Micronutrients in critically ill patients with severe acute kidney injury – a prospective study. Sci Rep 10, 1505.CrossRefGoogle ScholarPubMed
Whitfield, K, Bourassa, M, Adamolekun, B, et al. (2018) Thiamine deficiency disorders: diagnosis, prevalence, and a roadmap for global control programs. Ann NY Acad Sci 1430, 343.CrossRefGoogle Scholar
McClave, S, Taylor, B, Martindale, R, et al. (2016) Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enter Nutr 40, 159211.CrossRefGoogle Scholar
Druml, W (2013) The renal failure patient. World Rev Nutr Dietetics 105, 126135.CrossRefGoogle ScholarPubMed
Cano, N, Fiaccadori, E, Tesinsky, P, et al. (2006) ESPEN guidelines on enteral nutrition: adult renal failure. Clin Nutr 25, 295310.CrossRefGoogle ScholarPubMed
Cruickshank, A, Telfer, A & Shenkin, A (1988) Thiamine deficiency in the critically ill. Intensive Care Med 14, 384387.CrossRefGoogle ScholarPubMed
Collie, J, Greaves, R, Jones, O, et al. (2017) Vitamin B1 in critically ill patients: needs and challenges. Clin Chem Lab Med 55, 16521668.CrossRefGoogle ScholarPubMed
Bukhari, F, Moradi, H, Gollapudi, P, et al. (2011) Effect of chronic kidney disease on the expression of thiamin and folic acid transporters. Nephrol Dial Transplant 26, 21372144.CrossRefGoogle ScholarPubMed
Manzanares, W & Hardy, G (2011) Thiamine supplementation in the critically ill. Curr Opin Clin Nutr Metab Care 14, 610617.CrossRefGoogle ScholarPubMed
Costa, N, Gut, A, de Souza Dorna, M, et al. (2014) Serum thiamine concentration and oxidative stress as predictors of mortality in patients with septic shock. J Crit Care 29, 249252.CrossRefGoogle ScholarPubMed
Donnino, M, Andersen, L, Chase, M, et al. (2016) Randomized, double-blind, placebo-controlled trial of thiamine as a metabolic resuscitator in septic shock: a pilot study. Crit Care Med 44, 360367.CrossRefGoogle ScholarPubMed
Moskowitz, A, Andersen, L, Cocchi, M, et al. (2017) Thiamine as a renal protective agent in septic shock. a secondary analysis of a randomized, double-blind, placebo-controlled Trial. Ann Am Thoracic Soc 14, 737741.CrossRefGoogle ScholarPubMed
Levey, A & James, M (2017) Acute kidney injury. Ann Intern Med 167, ITC66ITC80.CrossRefGoogle ScholarPubMed
Shen, Y, Zhang, W & Shen, Y (2019) Early diuretic use and mortality in critically ill patients with vasopressor support: a propensity score-matching analysis. Crit Care 23, 9.CrossRefGoogle ScholarPubMed
Andrassy, K (2013) Comments on ‘KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease’. Kidney Int 84, 622623.CrossRefGoogle ScholarPubMed
Huber, M, Ozrazgat-Baslanti, T, Thottakkara, P, et al. (2016) Cardiovascular-specific mortality and kidney disease in patients undergoing vascular surgery. JAMA Surg 151, 441450.CrossRefGoogle ScholarPubMed
Siew, E, Ikizler, T, Matheny, M, et al. (2012) Estimating baseline kidney function in hospitalized patients with impaired kidney function. Clin J Am Soc Nephrol: CJASN 7, 712719.CrossRefGoogle ScholarPubMed
Angeli, P, Ginès, P, Wong, F, et al. (2015) Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. J Hepatol 62, 968974.CrossRefGoogle ScholarPubMed
Quan, H, Sundararajan, V, Halfon, P, et al. (2005) Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 43, 11301139.CrossRefGoogle ScholarPubMed
Zhao, G, Xu, C, Ying, J, et al. (2020) Association between furosemide administration and outcomes in critically ill patients with acute kidney injury. Crit Care 24, 75.CrossRefGoogle ScholarPubMed
National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39, S1S266.Google Scholar
Frank, R, Leeper, F & Luisi, B (2007) Structure, mechanism and catalytic duality of thiamine-dependent enzymes. Cell Mol Life Sci: CMLS 64, 892905.CrossRefGoogle ScholarPubMed
Zarbock, A, Gomez, H & Kellum, J (2014) Sepsis-induced acute kidney injury revisited: pathophysiology, prevention and future therapies. Curr Opin Crit Care 20, 588595.CrossRefGoogle ScholarPubMed
Donnino, M, Miller, J, Goyal, N, et al. (2007) Effective lactate clearance is associated with improved outcome in post-cardiac arrest patients. Resuscitation 75, 229234.CrossRefGoogle ScholarPubMed
Honore, P, Jacobs, R, De Waele, E, et al. (2016) Renal blood flow and acute kidney injury in septic shock: an arduous conflict that smolders intrarenally? Kidney Int 90, 2224.CrossRefGoogle ScholarPubMed
Moskowitz, A & Donnino, M (2020) Thiamine (vitamin B1) in septic shock: a targeted therapy. J Thorac Dis 12, S78S83.CrossRefGoogle ScholarPubMed
Amrein, K, Oudemans-van Straaten, H & Berger, M (2018) Vitamin therapy in critically ill patients: focus on thiamine, vitamin C, and vitamin D. Intensive Care Med 44, 19401944.CrossRefGoogle ScholarPubMed
Manzetti, S, Zhang, J & van der Spoel, D (2014) Thiamin function, metabolism, uptake, and transport. Biochemistry 53, 821835.CrossRefGoogle ScholarPubMed
Umezawa, K (2006) Inhibition of tumor growth by NF-κB inhibitors. Cancer Sci 97, 990995.CrossRefGoogle ScholarPubMed
Miyamoto, Y, Aso, S, Iwagami, M, et al. (2020) Association between IV Thiamine and mortality in patients with septic shock: a nationwide observational study. Crit Care Med 48, 11351139.CrossRefGoogle ScholarPubMed
Fujii, T, Luethi, N, Young, P, et al. (2020) Effect of vitamin c, hydrocortisone, and thiamine vs hydrocortisone alone on time alive and free of vasopressor support among patients with septic shock: the VITAMINS randomized clinical trial. JAMA 323, 423431.CrossRefGoogle ScholarPubMed
Ali, T, Khan, I, Simpson, W, et al. (2007) Incidence and outcomes in acute kidney injury: a comprehensive population-based study. J Am Soc Nephrol: JASN 18, 12921298.CrossRefGoogle ScholarPubMed
Wu, V, Huang, T, Lai, C, et al. (2011) Acute-on-chronic kidney injury at hospital discharge is associated with long-term dialysis and mortality. Kidney Int 80, 12221230.CrossRefGoogle ScholarPubMed
Supplementary material: File

Li et al. supplementary material

Li et al. supplementary material

Download Li et al. supplementary material(File)
File 20 KB

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Associations between early thiamine administration and clinical outcomes in critically ill patients with acute kidney injury
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Associations between early thiamine administration and clinical outcomes in critically ill patients with acute kidney injury
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Associations between early thiamine administration and clinical outcomes in critically ill patients with acute kidney injury
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *