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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2019, Number 2

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An Med Asoc Med Hosp ABC 2019; 64 (2)

Early diagnosis of acute kidney injury in patients with sepsis in the emergency department

Paz CDC, Tapia IEX, Sánchez CA, Montiel FHM

Language: Spanish
References: 20
Page: 104-110
PDF size: 226.77 Kb.


ABSTRACT

Introduction: The incidence of sepsis and acute kidney injury in critical patients is gradually increasing, both indicate a poor prognosis with higher morbidity and mortality. Failure on acute diagnosis may delay the onset of an adequate therapy which may cause an unfavorable outcome, such as the need for renal replacement therapy, generating high costs to the health system. The validation of new methods that identify the presence of acute kidney injury in its early stages is needed. Objective: To demonstrate which is the earliest marker for the diagnosis of acute kidney injury in patients with sepsis, including creatinine, cystatin C, urinary sediment and N-GAL. Material and methods: A prospective, longitudinal and descriptive study is presented, with data obtained from patients with sepsis who attended to the Centro Medico ABC emergency department between July 2017 and July 2018. Results: Cylinders in urine and cystatin C had the same capacity to detect cases of acute kidney injury on admission (sensitivity 71.4% and specificity 77.8%). N-GAL showed a high sensitivity (greater than 85%) and a specificity of 100% at hospital admission and also maintained a high sensitivity of 87.5%, although its specificity was reduced due to transitions between patients from sick to healthy. Conclusions: In this study we found that the N-GAL is the most reliable biomarker for the diagnosis and prognosis of acute kidney injury compared to creatinine, cystatin C and urinary sediment. Its urinary levels increased much earlier. Without being modified by the patient’s previous condition.


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