Protective Effects of Xuebijing on AKI in Patients with Community-Acquired Pneumonia

Background: Patients with community-acquired pneumonia (CAP) frequently suffer from acute kidney injury (AKI), which has a detrimental impact on both the long- and short-term prognosis. We will evaluate the potential protective effect of Xuebijing (XBJ) against AKI development in CAP patients. Methods: In this retrospective cohort study, we analyzed 3468 adult CAP patients admitted between January 2014 and May 2017. Exclusion criteria included pre-existing AKI at admission, incomplete medical records, insufficient serum creatinine measurements (<2 tests), and regular dialysis or end-stage renal disease. Participants were stratified into two cohorts: XBJ recipients (n=413) and controls (n=3055). The primary outcome was AKI occurrence during hospitalization. We employed 1:1 propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) to address confounding factors, supplemented by multivariate logistic regression and subgroup analyses. Results: The cohort (median age 76 [IQR 61-83]; 59.3% male) demonstrated significant AKI risk reduction in XBJ recipients post-PSM (406 matched pairs). The XBJ group showed lower AKI incidence (11.1% vs. 19.0%; OR 0.53, 95% CI 0.36-0.79), with consistent findings in IPTW modeling (OR 0.60, 95% CI 0.42-0.84) and multivariate analysis (OR 0.55, 95% CI 0.36-0.77). Subgroup analyses confirmed robustness across demographic and clinical strata (interaction P-values 0.136-0.855). Notably, XBJ demonstrated stage-specific protection against AKI stage 1 (OR 0.49, 95% CI 0.29-0.82) and stage 2 (OR 0.33, 95% CI 0.15-0.76), though no significant association was observed with AKI stage 3 or renal replacement therapy requirements. Conclusion: XBJ is associated with reduced AKI risk in CAP patients, particularly in early-stage renal injury. These findings position XBJ as a promising therapeutic intervention that may expand clinical options for AKI prevention in CAP management.Association between XBJ and the occurrence of AKI in patients with community-acquired pneumonia.