- To evaluate the predictive ability of biomarkers for major adverse kidney events (Make 30) at day 30 in critically ill cirrhotic patients
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Kushal Kekan,Smita Divyaveer,Madhumita Premkumar,Kamal Kajal,Imraan Rather,Harbir Singh Kohli
2022 ; 2022(1):
- 논문분류 :
- 춘계학술대회 초록집
Objective: To evaluate whether plasma KIM 1, NGAL and Cystatin C are associated with MAKE 30 i.e. either rise of creatinine> 40%, requirement of dialysis, death at day 30.
Methods: All cirrhotic patients with critical illness admitted to intensive care unit were screened. Clinical data and plasma baseline samples were recorded and collected. Patients were followed up for 30 days. Achievement of either MAKE 30 was a positive outcome. Multi-variate analysis was used for statistics to evaluate association of biomarkers with MAKE 30
Results: Total of 70 patients were analysed. Cirrhosis etiology: Hepatitis C: 4; Hepatitis B: 6; Alcoholic Hepatitis: 38; NAFLD/NASH: 14; malignancy: 7; sepsis: 10; others: 8; overlapping conditions: 28. AKI developed in 37 patients. Total of 55 patients developed any of MAKE 30 and 15 had no MAKE 30. Individual MAKE 30 events: Death: 52; dialysis requirement: 3; rise in creatinine > 40%: 25. Number of patients on ventilator: 23; number of patients on vasopressor support: 24. Table 1. shows baseline characteristics with average and SD. Table 2. shows association of biomarkers with outcome.
Conclusions: The main component of MAKE 30 driving the outcome was death. The association of the kidney biomarkers KIM 1, NGAL, Cystatin C with MAKE 30 was not found to be statistically significant. Studies with larger number and testing of biomarkers at the earliest possible time, even before admission to ICU may establish whether the biomarkers have utility in predicting outcomes.