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2019, Number 3

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Med Crit 2019; 33 (3)

Renal angina: «The beginning of the end»

Cruz LJ,  Monares ZE, Galindo MCA, Frías ARM, Barrón MC, Santana HGP
Full text How to cite this article 10.35366/88504

DOI

DOI: 10.35366/88504
URL: https://dx.doi.org/10.35366/88504

Language: Spanish
References: 6
Page: 121-124
PDF size: 176.01 Kb.


Key words:

Acute kidney injury, risk, ritically ill patient, renal angina.

ABSTRACT

Acute kidney injury (AKI) is one of the most common entities in the intensive care area. It occurs in up to 50% of patients admitted to the intensive care unit (ICU). New tools to detect AKI risk using highly accessible routine information have been developed (AKI predictor). The goal is to determine the performance of the AKI predictor tool to detect renal damage and renal replacement therapy (RRT) requirement in adult patients admitted to the ICU.
Material and methods: Demographic, biochemical, clinical variables and AKI predictor percentages at admission and at 24 hours were retrospectively collected of every patient admitted in an 8 months period, likewise the concept of renal damage was determined, defined as requirement of RRT and/or an increment of creatinine ≥ 0.3 mg/dL in 24 hours and/or urine output ‹ 0.5 mL/kg/h at 48 hours. Receiver operating characteristics curves were developed in order to determine the performance of the AKI predictor to detect renal damage or RRT requirement by separate.
Results: 95 patients were included in the analysis, those with renal damage showed higher illness severity by Sequential Organ Failure Assessment score, higher proportion of these patients presented sepsis, need for vasopressors, mortality and longer UCI stay. AKI predictor tool showed a significant area under the curve (AUC) of 0.76 for renal damage detection, 0.85 for requirement of RRT and calculated at 24 hours an AUC of 0.91 for RRT requirement.
Conclusions: The AKI predictor tool it is shown as a viable option in daily practice for the dynamic evaluation of those patients who will show renal damage progression until its final consequence RRT.


REFERENCES

  1. Thomas ME, Blaine C, Dawnay A, Devonald MA, Ftouh S, Laing C, et al. The definition of acute kidney injury and its use in practice. Kidney Int. 2015;87(1):62-73.

  2. Flechet M, Güiza F, Schetz M, Wouters P, Vanhorebeek I, Derese I, et al. AKIpredictor, an online prognostic calculator for acute kidney injury in adult critically ill patients: development, validation and comparison to serum neutrophil gelatinase-associated lipocalin. Intensive Care Med. 2017;43(6):764-773.

  3. Clinical Practice Guide of KDIGO for Acute Kidney Injury. Renal disease: improvement of overall results (KDIGO). Working group on acute renal injuries. Kidney Int Suppl. 2012;2:124-138.

  4. Goldstein SL, Chawla LS. Renal angina. Clin J Am Soc Nephrol. 2010;5(5):943-949.

  5. Kellum JA, Bellomo R, Ronco C. Kidney attack. JAMA. 2012;307(21):2265-2266.

  6. Erdfelder F, Grigutsch D, Hoeft A, Reider E, Matot I, Zenker S. Dynamic prediction of the need for renal replacement therapy in intensive care unit patients using a simple and robust model. J Clin Monit Comput. 2017;31(1):195-204.




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Med Crit. 2019;33