Carbonell MLF, Saucedo SG, Fraire FIS, Tovar CBE

Language: Spanish
References: 14
Page: 99-103
PDF size: 583.55 Kb.

ABSTRACT

Introduction: sepsis often induces organ dysfunction, with pulmonary and renal dysfunction being more common, the latter being more prevalent among critically ill patients; half of the cases of acute kidney injury are patients who present with sepsis or septic shock. In sepsis survival campaigns, it has been shown that norepinephrine is the vasopressor of choice. In cases where objective blood pressure levels are not achieved, vasopressin can be added as a second vasopressor support. The role of genetic polymorphisms has gained great interest as potential determinants of susceptibility to worse clinical outcomes. Objective: determine the association of the genetic polymorphism of the AVPR1B gene (rs28418396) with the development of acute kidney injury in patients with septic shock in the intensive care unit of the Centenario Hospital Miguel Hidalgo. Material and methods: prospective case-control study: 200 patients with septic shock were included. Genetic material was extracted to identify the presence of the aforementioned polymorphism. Statistical analysis was performed on qualitative variables, calculating their frequencies; for quantitative variables, the mean or median and standard deviation or error were recorded. Variable correlation was performed using Pearson’s correlation coefficient. Results: 50% were men and women, mean age of 45.1 years, 65.5% required double vasopressor support, 48.5% presented the polymorphism, 71% received nephrotoxic drugs, 64% corticosteroids, mortality of 29.5%. The presence of the polymorphism and AKI demonstrated a very high positive correlation (r = 0.850), with a value of p = 0.00 indicating a strong association between the variables. Conclusion: the correlation observed between genetic polymorphisms and AKI supports what has been described in the literature about the importance of genetics in susceptibility to kidney injury. These results underline the need to continue investigating the interactions between genetic and therapeutic factors to optimize the management of critically ill patients and personalize interventions based on genetic predisposition.

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