B54-24 Frequency, Characterization, and Mortality of Renal-Lung Syndrome in a Third-Level Intensive Care Unit (ICU)

Rationale The renal-lung syndrome represents a constellation of different pathologies that cause rapid progressive glomerulonephritis along with diffuse alveolar hemorrhage. It is estimated that the main pathology causing this syndrome is ANCA-associated vasculitis (70% of cases); however, there are no Latin American studies that discuss its incidence or characterization in the ICU. Objective and Methods To determine the frequency, clinical characteristics, and 30-day mortality of patients with renal-lung syndrome in the ICU. A retrospective observational study that included all patients admitted to the ICU with a diagnosis of renal-lung syndrome from January 2022 to August 2025. Results A total of 12 patients were recruited, of whom 5 were women (41%). The most common autoimmune disease observed was systemic lupus erythematosus (SLE) (58.3%), followed by ANCA-associated vasculitis (41.6%). Half of the patients required continuous renal replacement therapy, with 91.6% needing therapeutic plasma exchange (11 patients), and all required invasive mechanical ventilation with pronation. The average ICU stay was 12.9 days. The 30-day mortality rate was 33.3% (4 patients), with mean APACHE score of 19.9 points, SOFA score of 9.7 points, and SAPS of 41.6 points. Conclusions Although international literature reports that the most frequent form of renal-lung syndrome is ANCA-associated vasculitis, in our population, there was a higher prevalence of SLE, a disease that presents this syndrome in up to 70% of cases. Mortality has been reported by up to 50%, but it was slightly lower in our population, likely due to the use of extracorporeal therapies, which have demonstrated benefits in this type of patient.