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2024, Number 7

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Med Crit 2024; 38 (7)

Screening index for acute kidney injury in patients with septic shock

Arellano JRJ, Mendoza PE, Lozano NJJ

Language: Spanish
References: 26
Page: 552-561
PDF size: 327.20 Kb.


ABSTRACT

Introduction: the worldwide incidence of acute kidney injury (AKI) in sepsis is between 40 and 50%. Patients with sepsis and circulatory dysfunction have an increased mortality, that is why we propose the use of the S-AKI SS and R-AKI SS indexes as screening methods for AKI associated with sepsis with circulatory failure. Objective: to determine the odds ratio (OR), sensitivity (S) and area under the curve (AUC) of the S-AKI SS and R-AKI SS indexes as screening for AKI in septic shock. Material and methods: multicenter case-control study: retrospective, retrolective, observational and analytical in three hospital units in Mexico City with 40 patients hospitalized between 2022 and 2024 in the internal medicine and intensive care unit services, with a diagnosis of septic shock according to the Sepsis-3 criteria and/or clinical repercussion criteria of shock. The diagnosis of AKI in sepsis was made with the guidelines and recommendations of KDIGO and the 28th ADQI Consensus. Results: S-AKI SS under the SAKI criterion due to elevated Creatinine (Cr) above the upper limit (ULN) by SOFA obtained an OR of 12.5, IC 95% (2.2-70.1), S: 0.91, AUC: 0.841, IC 95% (0.72-0.96), p < 0.001; the use of the SAKI criterion for elevated Cr above the ULN by gender obtained OR: 10.5, IC 95% (1.9-58.5), S: 0.90, AUC: 0.810, IC 95% (0.67-0.94), p < 0.001. Elevated Cr by SOFA or gender without meeting KDIGO criteria for AKI has OR of 18, IC 95% (3.34-96.7), S: 0.89, AUC: 0.897, IC 95% (0.79-0.99), p < 0.001; OR: 18.3, IC 95% (3.13-107.2), S: 92, AUC: 0.852, IC 95% (0.72-0.97), p < 0.001, respectively. Conclusions: S-AKI SS and R-AKI SS can be used in patients with sepsis-associated AKI with circulatory dysfunction, due to statistically we show high OR, sensitivity and AUC in this research.


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