Plasma Renin Levels and One-Year Mortality in Critically Ill Patients with ARDS: Analysis of Trends, Predictive Value, and Survival Outcomes
By
Gabriele Melegari
Alessandro Belletti
Federica Arturi
Antonio Giansante
Arianna Gaspari
Fabio Gazzotti
Elisabetta Bertellini
Giovanni Landoni
Alberto Barbieri
June 23, 2026
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
Category Detail
Condition COVID-19-induced acute respiratory distress syndrome (ARDS) Key Mechanisms Renin-angiotensin-aldosterone system (RAAS) modulation of vascular tone and renal blood flow Target Population Critically ill patients with COVID-19-associated ARDS Care Setting Tertiary 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
