Renin and 1-year mortality in critically ill patients with ARDS: trajectories, discrimination, and survival analysis - Report - MDSpire

Renin and 1-year mortality in critically ill patients with ARDS: trajectories, discrimination, and survival analysis

  • By

  • Gabriele Melegari

  • Alessandro Belletti

  • Federica Arturi

  • Antonio Giansante

  • Arianna Gaspari

  • Fabio Gazzotti

  • Elisabetta Bertellini

  • Giovanni Landoni

  • Alberto Barbieri

  • June 23, 2026

  • 0 min

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Plasma Renin Levels and One-Year Mortality in Critically Ill Patients with ARDS

Overview

This study investigates the correlation between plasma renin concentration and 1-year mortality in critically ill patients with COVID-19-induced ARDS.

Background

Acute respiratory distress syndrome (ARDS) is a severe condition often associated with high mortality rates, particularly in critically ill patients. Traditional biomarkers like lactate and procalcitonin have limitations in predicting long-term outcomes. The renin–angiotensin–aldosterone system (RAAS) may provide additional prognostic information regarding mortality in ARDS patients.

Data Highlights

Time PointRenin Level Odds Ratiop-value
T0 (72 hours)1.940.002
T1 (120 hours)1.690.014
T2 (168 hours)2.52< 0.001

Key Findings

  • 46% of patients with COVID-19-associated ARDS died within one year.
  • Elevated renin levels at T0, T1, and T2 were significantly associated with 1-year mortality.
  • Kaplan–Meier survival curves showed significant divergence based on renin tertiles at T0 and T2.
  • Independent predictors of mortality included renin at T0, PaO₂/FiO₂ ratio at T0, and procalcitonin at T2.
  • The model demonstrated high discrimination performance with an AUC of 0.941.

Clinical Implications

Monitoring plasma renin levels in critically ill patients with ARDS may provide additional data for risk assessment.

Conclusion

Early plasma renin levels are linked to 1-year mortality in patients with severe COVID-19-induced ARDS.

Related Resources & Content

  1. Intensive Care Medicine, 2018 -- Association of Plasma sRAGE Levels with Mortality Risk in ARDS
  2. Intensive Care Medicine, 2024 -- Prevalence of Acute Kidney Injury and Associated Mortality in Randomized Trials of Acute Respiratory Distress Syndrome
  3. Intensive Care Medicine, 2025 -- Acute Respiratory Distress Syndrome in Cancer Patients: Findings from the YELENNA Multinational Observational Cohort Study
  4. Critical Care (Springer) — Subphenotypes of Morphological Characteristics in Acute Respiratory Distress Syndrome Associated with Acute Pancreatitis
  5. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026
  6. The circulating renin-angiotensin system and mortality among patients hospitalized for COVID-19
  7. Renin–angiotensin–aldosterone system activation in plasma as marker for prognosis in critically ill patients with COVID-19
  8. Shock prediction with dipeptidyl peptidase-3 and renin (SPiDeR) in hypoxemic patients with COVID-19 - ScienceDirect
  9. Annals of Intensive Care

Original Source(s)

Renin and 1-year mortality in critically ill patients with ARDS: trajectories, discrimination, and survival analysis

  • by Gabriele Melegari, Alessandro Belletti, Federica Arturi, Antonio Giansante, Arianna Gaspari, Fabio Gazzotti, Elisabetta Bertellini, Giovanni Landoni, Alberto Barbieri

  • June 23, 2026

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