Quintero-Aranda A, Nieblas-Beltrán LD, Dehesa-López E

Language: Spanish
References: 9
Page: 175-182
PDF size: 219.76 Kb.

ABSTRACT

Objective: To evaluate the performance of the renal angina index (RAI) to predict dialysis requirements in critically ill patients. Methodology: A retrospective cohort study including 150 patients admitted to the intensive care unit (ICU). RAI was calculated within 24 hours of admission. The diagnosis and staging of the acute kidney injury (AKI) episode were based on the serum creatinine criteria of the Acute Kidney Injury Network (AKIN). The sensitivity, specificity, positive and negative predictive values of the RAI to predict dialysis requirements were determined using ROC curve analysis. Resultados: The performance of the RAI to predict dialysis requirements was evaluated in the global population and patients with AKI during their ICU stay. The diagnostic performance was acceptable with an area under the curve (AUC) of 0.89 in the global population and 0.63 in patients with AKI. The cutoff point of›6 points for the RAI had a sensitivity of 100% in both populations, with a specificity of 73.5% in the global population and 7.9% in AKI population. The positive predictive value was 28% in the global population and 28.6% in patients with AKI, with a negative predictive value of 100% in both populations. Conclusions: The RAI ›6 within the first 24 hours had a positive predictive value of 98% to predict the development of AKI in critically ill patients; however, it had a low capacity to predict the dialysis requirements in critically ill patients who develop AKI (positive predictive value of 28.6%).

REFERENCES

1. Chertow GM, Burdick E, Honour M, BonventreJV, Bates DW. Acute kidney injury,mortality, length of stay, and costs in hospitalizedpatients. J Am Soc Nephrol. 2005;16(11):3365-70.

2. Parikh A, Shaw A. The economics of renalfailure and kidney disease in critically ill patients.Crit Care Clin. 2012;28(1):99-111, vii.

3. Susantitaphong P, Cruz DN, Cerda J, AbulfarajM, Alqahtani F, Koulouridis I, et al.World incidence of AKI: a meta-analysis.Clin J Am Soc Nephrol. 2013;8(9):1482-93.

4. Negi S, Koreeda D, Kobayashi S, Yano T,Tatsuta K, Mima T, et al. Acute kidney injury:Epidemiology, outcomes, complications,and therapeutic strategies. SeminDial. 2018;31(5):519-27.

5. Chawla LS, Goldstein SL, Kellum JA, RoncoC. Renal angina: concept and developmentof pretest probability assessment in acutekidney injury. Crit Care. 2015;19:93.

6. Cruz DN, Ferrer-Nadal A, Piccinni P, GoldsteinSL, Chawla LS, Alessandri E, et al. Utilizationof small changes in serum creatininewith clinical risk factors to assess the risk ofAKI in critically lll adults. Clin J Am SocNephrol. 2014;9(4):663-72.

7. Matsuura R, Srisawat N, Claure-Del GranadoR, Doi K, Yoshida T, Nangaku M, et al.Use of the Renal Angina Index in DeterminingAcute Kidney Injury. Kidney Int Rep.2018;3(3):677-83.

8. Fletcher RH, editor. Clinical EpidemiologyThe Essentials. 2014 ed. Philadelphia PA:Lippincott 2014.

9. Group KDIGOKAKIW. KDIGO Clinical PracticeGuideline for Acute Kidney Injury. KidneyInter. 2012;2:1-138.