Development and validation of quick Acute Kidney Injury-score (q-AKI) to predict acute kidney injury at admission to a multidisciplinary intensive care unit

• Published in: PloS one Vol. 14; no. 6; p. e0217424
• Main Authors: Ferrari, Fiorenza, Puci, Mariangela Valentina, Ferraro, Ottavia Eleonora, Romero-González, Gregorio, Husain-Syed, Faeq, Rizo-Topete, Lilia, Senzolo, Mara, Lorenzin, Anna, Muraro, Eva, Baracca, Antonio, Serrano-Soto, Mara, Molano Triviño, Alejandra, Coutinho Castro, Ana, De Cal, Massimo, Corradi, Valentina, Brendolan, Alessandra, Scarpa, Marta, Carta, Maria Rosa, Giavarina, Davide, Bonato, Raffaele, Iotti, Giorgio Antonio, Ronco, Claudio
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 20.06.2019; Public Library of Science (PLoS)
• Subjects: Acute kidney failure; Acute Kidney Injury - diagnosis; Acute Kidney Injury - physiopathology; Acute Kidney Injury - urine; Aged; Aged, 80 and over; Analysis; Biology and Life Sciences; Biomarkers; Care and treatment; Cell cycle; Chronic kidney failure; Critical Care; Critically ill persons; Death; Epidemiology; Epidermal growth factor receptors; Female; Gastrointestinal surgery; Glomerular Filtration Rate; Health aspects; Heart surgery; Hemodialysis; Hospital patients; Hospitals; Humans; Intensive care; Intensive Care Units; Kidney diseases; Kidneys; Laboratories; Lactates; Lactic acid; Literature reviews; Male; Medical research; Medicine and Health Sciences; Middle Aged; Nephrology; Obesity; Patient outcomes; Practice guidelines (Medicine); Prediction models; Public health; Registries; Retrospective Studies; Risk; Risk factors; Services; Tissue inhibitor of metalloproteinase 2; Transplants & implants; Colombia; Italy
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0217424

AKI is associated with increased risk of death, prolonged length of stay and development of de-novo chronic kidney disease. The aim of our study is the development and validation of prediction models to identify the risk of AKI in ICU patients up to 7 days. We retrospectively recruited 692 consecutive patients admitted to the ICU at San Bortolo Hospital (Vicenza, Italy) from 1 June 2016 to 31 March 2017: 455 patients were treated as the derivation group and 237 as the validation group. Candidate variables were selected based on a literature review and expert opinion. Admission eGFR< 90 ml/min /1.73 mq (OR 2.78; 95% CI 1.78-4.35; p<0.001); SOFAcv ≥ 2 (OR 2.23; 95% CI 1.48-3.37; p<0.001); lactate ≥ 2 mmol/L (OR 1.81; 95% CI 1.19-2.74; p = 0.005) and (TIMP-2)•(IGFBP7) ≥ 0.3 (OR 1.65; 95% CI 1.08-2.52; p = 0.019) were significantly associated with AKI. For the q-AKI score, we stratified patients into different AKI Risk score levels: 0-2; 3-4; 5-6; 7-8 and 9-10. In both cohorts, we observed that the proportion of AKI patients was higher in the higher score levels.