Renin and 1-year mortality in critically ill patients with ARDS: trajectories, discrimination, and survival analysis - Scorecard - 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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Clinical Scorecard: Plasma Renin Levels and One-Year Mortality in Critically Ill Patients with ARDS: Analysis of Trends, Predictive Value, and Survival Outcomes

At a Glance

CategoryDetail
ConditionCOVID-19-induced acute respiratory distress syndrome (ARDS)
Key MechanismsRenin-angiotensin-aldosterone system (RAAS) modulation of vascular tone and renal blood flow
Target PopulationCritically ill patients with COVID-19-associated ARDS
Care SettingTertiary intensive care unit

Key Highlights

  • Elevated plasma renin levels correlate with increased 1-year mortality in ARDS patients.
  • Renin levels measured at 72 hours post-ICU admission are significant predictors of mortality.
  • Kaplan–Meier survival curves show significant differences in survival based on renin tertiles.

Guideline-Based Recommendations

Diagnosis

  • Confirm SARS-CoV-2 infection via PCR.
  • Diagnose COVID-19-induced ARDS according to the Berlin definition.

Management

  • Follow national and international guidelines for ARDS management.
  • Utilize lung-protective ventilation and individualized PEEP.

Monitoring & Follow-up

  • Assess plasma renin levels at 72, 120, and 168 hours post-ICU admission.

Risks

  • Increased plasma renin levels are associated with higher mortality risk.

Patient & Prescribing Data

104 mechanically ventilated individuals with COVID-19-associated ARDS

Chronic RAAS antagonists were halted upon ICU admission.

Clinical Best Practices

  • Implement conservative fluid management and vasopressor support to maintain adequate perfusion.
  • Consider inotropic agents in cases of suspected cardiac dysfunction.

Related Resources & Content

    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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