López AFG, Jiménez CC, González PK

Language: Spanish
References: 16
Page: 35-42
PDF size: 334.18 Kb.

ABSTRACT

Introduction: sepsis-induced acute kidney injury (AKI) is a syndrome caused by infections or the body’s response to them, where diagnosis using serum creatinine and urine output may be limited. Objective: to evaluate the usefulness of the renal resistance index (RRI) and interleukin-6 (IL-6) compared to the ARMO score for predicting AKI in critically ill patients with sepsis. Material and methods: a longitudinal, prospective, analytical study with non-probability sampling of consecutive patients with sepsis admitted to the Intensive Care Unit (ICU) of the UMAE del Bajío. Patients underwent evaluation using the ARMO score, serum IL-6 levels, and RRI upon ICU admission between March and August 2025. Results: forty-seven patients with sepsis were included. The mean age was 48.7 years; there was a slight predominance of women (53.19%). The most frequent comorbidities were systemic hypertension (48%) and type 2 diabetes mellitus (34.04%). The study identified age, male sex, need for vasopressors, thrombocytopenia, presence of liver failure, elevated creatinine, high IL-6 levels, and ARMO scores as factors associated with increased mortality in patients with sepsis. A moderate positive correlation was observed between IL-6 levels and the severity of AKI. The IRR showed limited diagnostic capacity for predicting AKI (AUC = 0.60), while the ARMO score demonstrated excellent performance in predicting sepsis-associated AKI with a cutoff point of 5 points and an AUC of 0.96. Conclusion: the ARMO score proved to be the most reliable marker for identifying patients at risk of developing AKI in the context of sepsis.

REFERENCES

1. Zarbock A, Nadim MK, Pickkers P, et al. Sepsis-associatedacute kidney injury: consensus report of the 28th AcuteDisease Quality Initiative workgroup. Nat Rev Nephrol.

2. 2023;19(6):401-417. Available in: http://dx.doi.org/10.1038/s41581-023-00683-32. Kahar LA. Interleukin-6 and procalcitonin as potential predictorsof acute kidney injury occurrence in patients with sepsis. RepBiochem Mol Biol. 2024;13(2):144-153. Available in: http://dx.doi.org/10.61186/rbmb.13.2.144

3. Jia HM, Jiang YJ, Zheng X, et al. The attributable mortality ofsepsis for acute kidney injury: a propensity-matched analysisbased on multicenter prospective cohort study. Ren Fail.2023;45(1):2162415. Available in: http://dx.doi.org/10.1080/0886022X.2022.2162415

4. Wang D, Sun T, Liu Z. Sepsis-associated acute kidney injury.Intensive Care Res. 2023;3(4):251-258. Available in: http://dx.doi.org/10.1007/s44231-023-00049-0

5. Ramírez MAY, Francisco ACA. Factores de riesgo para lesiónrenal aguda en pacientes con diagnóstico de sepsis. [Internet].[Veracruz, México]: Universidad Veracruzana; 2019. Disponibleen: http://cdigital.uv.mx/handle/1944/48702

6. Darabont R, Mihalcea D, Vinereanu D. Current insightsinto the significance of the renal resistive index inkidney and cardiovascular disease. Diagnostics (Basel).2023;13(10):1687. Available in: http://dx.doi.org/10.3390/diagnostics13101687

7. Lubis B, Amelia P, Adriansyah R, Prima A. The correlationbetween mean perfusion pressure (MPP) and renal resistive index(RRI) in sepsis patients in the intensive care unit (ICU). J MedChem Sci. 2025;8(1):1-6. Available in: https://www.jmchemsci.com/article_212978_c8906d04e76d70b7877387e4e854bae8.pdf

8. Rajangam M, Nallasamy K, Bhatia A, Kumar V, Kaur P, AnguranaSK. Renal resistive index by point of care ultrasound to predictsepsis associated acute kidney injury in critically ill children.Pediatr Nephrol. 2024;39(12):3581-3589. Available in: http://dx.doi.org/10.1007/s00467-024-06392-8

9. Zaitoun T, Megahed M, Elghoneimy H, et al. Renal arterialresistive index versus novel biomarkers for the early predictionof sepsis-associated acute kidney injury. Intern Emerg Med.2024;19(4):971-981. Available in: http://dx.doi.org/10.1007/s11739-024-03558-y

10. Saeed Abdelaziz M, Hosney MR, Ahmed MS, AbuelmajdAA. Predictive value of Doppler renal resistive index forprediction of acute kidney injury in septic patients in intensivecare unit. QJM:An International Journal of Medicine.2023;116(Supplement_1). Available in: http://dx.doi.org/10.1093/qjmed/hcad069.010

11. Chen X-Q, Zhang Q-J, Lai X-W. Predictive value of renalresistive index combined with plasma biomarkers of endothelialcell activation for persistent acute kidney injury in patients withseptic shock. Hong Kong J Emerg Med. 2024;31(5):213-223Available in: http://dx.doi.org/10.1002/hkj2.12037

12. Mora-Coello CL, Armendáriz-Carvajal AC, Vélez-Paez JL.Predictive scale of acute kidney failure in sepsis (ARMO). RevSalud Publica (Bogota). 2023;25(2):105124. Available in: http://dx.doi.org/10.15446/rsap.V25n2.105124

13. Takeuchi T, Flannery AH, Liu LJ, Ghazi L, Cama-Olivares A,Fushimi K, et al. Epidemiology of sepsis-associated acute kidneyinjury in the ICU with contemporary consensus definitions. CritCare. 2025;29(1):128. Available in: http://dx.doi.org/10.1186/s13054-025-05351-5

14. Song MJ, Jang Y, Legrand M, et al. Epidemiology of sepsisassociatedacute kidney injury in critically ill patients: amulticenter, prospective, observational cohort study in SouthKorea. Crit Care. 2024;28(1):383. Available in: http://dx.doi.org/10.1186/s13054-024-05167-9

15. Sundalic S, Kosuta I, Barsic LI, et al. Interleukin-6 and leukocytecell population data in newly diagnosed sepsis-A prospectivestudy. Medicina (Kaunas). 2025;61(3):468. Available in: http://dx.doi.org/10.3390/medicina61030468

16. Shimazui T, Nakada TA, Tateishi Y, Oshima T, Aizimu T, OdaS. Association between serum levels of interleukin-6 on ICUadmission and subsequent outcomes in critically ill patients withacute kidney injury. BMC Nephrol. 2019;20(1):74. Available in:http://dx.doi.org/10.1186/s12882-019-1265-6