Shyam Radhey, Patel Munna Lal, Kumar Dhananjay, Sachan Rekha, Chaudhary Shyam Chand, Gupta K K
Department of Geriatric Intensive Care Unit (Anaesthesiology) DGMH, King George's Medical University, Lucknow, Uttar Pradesh, India.
Department of Internal Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
Int J Crit Illn Inj Sci. 2020 Sep;10(Suppl 1):6-10. doi: 10.4103/IJCIIS.IJCIIS_80_19. Epub 2020 Sep 16.
Sepsis is one of the most common triggering factors for acute kidney injury (AKI). The aim of the study is to evaluate the outcome in sepsis with AKI and determine the prognostic value of urinary neutrophil gelatinase-associated lipocalin (NGAL) in septicemic AKI.
This prospective follow-up study was carried out over a period of 1 year after ethical clearance from the Institutional Ethics committee, a total 165 cases of septicemia were recruited, of which 15 patients were dropped out, 150 patients were identified suffering from septicemia defined as per the organ dysfunction criteria (according to third international consensus 2016) and patients of AKI defined as per the Kidney Disease Improving Global Outcomes 2012 criteria).
Out of 150 patients of septicemia enrolled in the study, only 38 (25.33%) suffering from AKI were classified as Group I and rest 112 (74.67%) patients of septicemia not suffering from AKI were classified as Group II. In total, 60.0% (90) patients were discharged from the hospital, rest of the patients (40%) expired. Mean duration of survival was higher in Group II (21.29 ± 1.89 days) as compared to Group I (13.67 ± 1.06 days). Cases with ≥121.90 urine NGAL, rate of mortality (41.7%), were higher as compared to alive patients discharged (34.4%).
Sequential organ failure assessment score, hospital stay, and mortality were high in septicemic patients with AKI as compared to sepsis without AKI. Survival of patients also not good with septic AKI, those patients who had high NGAL value had poor prognosis.
脓毒症是急性肾损伤(AKI)最常见的触发因素之一。本研究旨在评估脓毒症合并AKI的预后,并确定尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在脓毒症性AKI中的预后价值。
本前瞻性随访研究在获得机构伦理委员会伦理批准后进行,为期1年,共招募了165例败血症患者,其中15例退出研究,150例患者被确定患有根据器官功能障碍标准(根据2016年第三次国际共识)定义的败血症以及根据2012年改善全球肾脏病预后组织标准定义的AKI患者。
在纳入研究的150例败血症患者中,只有38例(25.33%)患有AKI的患者被分类为I组,其余112例(74.67%)未患AKI的败血症患者被分类为II组。总共有60.0%(90例)患者出院,其余患者(40%)死亡。II组的平均生存时间(21.29±1.89天)高于I组(13.67±1.06天)。尿NGAL≥121.90的病例死亡率(41.7%)高于出院存活患者(34.4%)。
与无AKI的脓毒症患者相比,脓毒症合并AKI患者的序贯器官衰竭评估评分、住院时间和死亡率更高。脓毒症性AKI患者的生存率也不佳,NGAL值高的患者预后较差。