@article {Darmon1347, author = {Darmon, Michael and Clec{\textquoteright}h, Christophe and Adrie, Christophe and Argaud, Laurent and Allaouchiche, Bernard and Azoulay, Elie and Bouadma, Lila and Garrouste-Orgeas, Ma{\"\i}t{\'e} and Haouache, Hakim and Schwebel, Carole and Goldgran-Toledano, Dany and Khallel, Hatem and Dumenil, Anne-Sylvie and Jamali, Samir and Souweine, Bertrand and Zeni, Fabrice and Cohen, Yves and Timsit, Jean-Fran{\c c}ois}, title = {Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients}, volume = {9}, number = {8}, pages = {1347--1353}, year = {2014}, doi = {10.2215/CJN.08300813}, publisher = {American Society of Nephrology}, abstract = {Background and objectives Increasing experimental evidence suggests that acute respiratory distress syndrome (ARDS) may promote AKI. The primary objective of this study was to assess ARDS as a risk factor for AKI in critically ill patients.Design, setting, participants, \& measurements This was an observational study on a prospective database fed by 18 intensive care units (ICUs). Patients with ICU stays \>24 hours were enrolled over a 14-year period. ARDS was defined using the Berlin criteria and AKI was defined using the Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease criteria. Patients with AKI before ARDS onset were excluded.Results This study enrolled 8029 patients, including 1879 patients with ARDS. AKI occurred in 31.3\% of patients and was more common in patients with ARDS (44.3\% versus 27.4\% in patients without ARDS; P\<0.001). After adjustment for confounders, both mechanical ventilation without ARDS (odds ratio [OR], 4.34; 95\% confidence interval [95\% CI], 3.71 to 5.10) and ARDS (OR, 11.01; 95\% CI, 6.83 to 17.73) were independently associated with AKI. Hospital mortality was 14.2\% (n=1140) and was higher in patients with ARDS (27.9\% versus 10.0\% in patients without ARDS; P\<0.001) and in patients with AKI (27.6\% versus 8.1\% in those without AKI; P\<0.001). AKI was associated with higher mortality in patients with ARDS (42.3\% versus 20.2\%; P\<0.001).Conclusions ARDS was independently associated with AKI. This study suggests that ARDS should be considered as a risk factor for AKI in critically ill patients.}, issn = {1555-9041}, URL = {https://cjasn.asnjournals.org/content/9/8/1347}, eprint = {https://cjasn.asnjournals.org/content/9/8/1347.full.pdf}, journal = {Clinical Journal of the American Society of Nephrology} }