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Renal Biomarker combinations predict early CRRT need in a mixed ICU population

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Published: Jul 7, 2022
DOI: https://doi.org/10.12681/healthresj.28926
Keywords:
acute kidney injury continuous renal replacement therapy NGAL cystatine C.
Dimitrios Panagidis
1st Department of Critical Care, National and Kapodistrian University of Athens, Medical School, ‘Evangelismos’ General Hospital, Athens, Greece
https://orcid.org/0000-0003-4666-4550
Epameinondas Angelopoulos
1st Department of Critical Care, National and Kapodistrian University of Athens, Medical School, ‘Evangelismos’ General Hospital, Athens, Greece
https://orcid.org/0000-0003-3966-6961
Panagiota Tsiara
Biochemistry Laboratory, ‘Evangelismos’ General Hospital, Athens, Greece
Serafim Nanas
1st Department of Critical Care, National and Kapodistrian University of Athens, Medical School, ‘Evangelismos’ General Hospital, Athens, Greece
Eleni Magira
1st Department of Critical Care, National and Kapodistrian University of Athens, Medical School, ‘Evangelismos’ General Hospital, Athens, Greece
Stelios Kokkoris
1st Department of Critical Care, National and Kapodistrian University of Athens, Medical School, ‘Evangelismos’ General Hospital, Athens, Greece
https://orcid.org/0000-0003-1082-8488
Abstract

Background: Acute kidney injury (AKI) is associated with markedly increased morbidity and mortality in critically ill patients and often necessitates the use of continuous renal replacement therapy (CRRT). The aim of the present study was to compare the predictive performance of urine neutrophil gelatinase (uNGAL), plasma cystatin C (pCysC), serum creatinine (sCr), and their combinations for CRRT requirement within the first 7 days post-admission in a general ICU.

Method and material: A total of 81 consecutive ICU patients were included in the analysis. AKI was defined according to AKIN criteria. Biomarkers’ predictive abilities were evaluated by the area under the receiver operating characteristics (AUC-ROC) curves.

Results and Conclusions: AKI occurred in 21% of patients and 14% of them needed CRRT 7 days post-admission. The two novel biomarkers, as well as sCr had moderate predictive abilities for CRRT requirement. The most efficient combinations (sCr+ uNGAL) and (sCr+uNGAL+pCysC) had better AUC-ROCs (0.845 and 0.84, respectively) than that of any individual biomarker (sCr, pCysC, uNGAL, with AUC-ROCs 0.81, 0.74 and 0.80, respectively). Renal biomarker combinations had better predictive characteristics for CRRT need within one week post admission as compared to each biomarker alone.

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