Naslov
Kinetic estimated Glomerular Filtration Rate as an effective approach in timely diagnosis prediction of Acute Kidney Injury in critically Ill septic patients

Autori
Lijović, Lada ; Pelajić, Stipe ; Hawchar, Fatime ; Minev, Ivaylo ; Cermaria Soares da Silva, Beatriz Helena ; Angelucci, Alessandra

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
European Journal of Anaesthesiology, Volume 40 | e- Supplement 61 | June 2023 / Samama, Charles Marc - Avenel, NJ 07001 : Wolters Kluwer, 2023, 279-280

Skup
Euroanaesthesia 2023

Mjesto i datum
Glasgow, Ujedinjeno Kraljevstvo, 03.06.2023. - 05.06.2023

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Acute kidney injury ; Early detection ; Glomerular filtration rate ; Kinetic eGFR

Sažetak
Background and Goal of Study: The incidence of acute kidney injury (AKI) in the Intensive Care Unit (ICU) is from 20% to more than 50% in septic patients and is associated with both short- and longterm adverse outcomes. Thus, accurate and actionable diagnosis of AKI ahead of time is important to prevent or alleviate renal dysfunction. The purpose of this study was to evaluate the timely performance of Kinetic estimated Glomerular Filtration Rate (KeGFR) in predicting AKI in critically ill septic patients. Materials and Methods: Our work is a retrospective analysis on septic ICU patients who developed AKI using the data of AmsterdamUMCdb, the first freely available European ICU database. The reference standard classification for AKI was the Kidney Disease: Improving Global Outcomes (KDIGO), based on serum creatinine and urine output (UO). For our prediction of AKI, stages by combination of KeGFR and UO were defined. To calculate the KeGFR, a modified expression by O’Sullivan was used. Classifications were compared by length of ICU stay (LOS), need for renal replacement therapy and 28-day mortality. Predictive performance and time between prediction and diagnosis were calculated. Results: Our cohort consisted of 2492 patients, 1560 (62.0%) of them were diagnosed with AKI by KDIGO and 1706 (68.5%) by KeGFR criteria. Disease stages had agreement of kappa=0.77, with KeGFR sensitivity 93.2%, specificity 73.0% and accuracy 85.7%. Median time to recognition of AKI Stage 1 was 13.2 h faster for KeGFR, and 7.5 h and 5.0 h for Stages 2 and 3 (Figure 1). Outcomes revealed a slight difference in LOS and 28-day mortality for Stage 1. Conclusion: According to our study, KeGFR combined with UO criteria showed a distinguished efficiency in predicting the diagnosis of AKI. Compared to KDIGO, deterioration of renal function was identified earlier, most prominently in less severe stages of AKI. Saving time by early prediction, clinicians may better deal with prevention and alleviation of renal insufficiency in critically ill septic patients.

Izvorni jezik
Engleski

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