Tyagi Asha, Yadav Pooja, Salhotra Rashmi, Das Shukla, Singh Praveen K, Garg Devansh
Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India.
Department of Microbiology, University College of Medical Sciences and GTB Hospital, Delhi, India.
Indian J Crit Care Med. 2021 Sep;25(9):1013-1019. doi: 10.5005/jp-journals-10071-23966.
Patients with preeclampsia admitted to the intensive care unit (ICU) may have risk factors for acute kidney injury (AKI). Although the use of neutrophil gelatinase-associated lipocalcin (NGAL) to predict AKI is previously validated, we could locate only scanty data regarding the epidemiology of AKI and role of NGAL in preeclamptic patients admitted to ICU.
Patients with preeclampsia admitted to our ICU were included. The incidence and severity of AKI during the entire ICU stay were assessed using kidney disease improving global outcomes criteria, while the a priori risk factors and serum NGAL were also evaluated.
A total of 52 preeclamptic patients admitted to ICU were included, among whom the majority had eclampsia (75%). AKI developed in 25 (48.1%) patients with stages 1, 2, and 3 in 56, 36, and 8%, respectively. The incidence of sepsis (16 vs 0%), shock (40 vs 7.4%), and anemia (84 vs 59.3%) was significantly greater in patients with AKI ( < 0.05). ICU mortality (28 vs 3.7%), duration of ICU, and hospital stay were significantly higher in patients who developed AKI ( < 0.05). There was no association of serum NGAL [274 (240-335) ng/mL] with AKI or the mortality ( = 0.725, 0.861); there was, however, a significant discriminatory value for eclampsia [ = 0.019; area under curve = 0.736 (95% confidence interval: 0.569-0.904)].
Although AKI is common among patients with preeclampsia admitted to ICU, serum NGAL does not predict its occurrence.
Tyagi A, Yadav P, Salhotra R, Das S, Singh PK, Garg D. Acute Kidney Injury in Severe Preeclamptic Patients Admitted to Intensive Care Unit: Epidemiology and Role of Serum Neutrophil Gelatinase-associated Lipocalcin. Indian J Crit Care Med 2021;25(9):1013-1019.
入住重症监护病房（ICU）的先兆子痫患者可能存在急性肾损伤（AKI）的危险因素。尽管此前已证实使用中性粒细胞明胶酶相关脂质运载蛋白（NGAL）来预测AKI，但我们仅能找到关于入住ICU的先兆子痫患者中AKI的流行病学及NGAL作用的少量数据。
纳入入住我们ICU的先兆子痫患者。在整个ICU住院期间，使用改善全球肾脏病预后组织（KDIGO）标准评估AKI的发生率和严重程度，同时评估先验危险因素和血清NGAL。
共纳入52例入住ICU的先兆子痫患者，其中大多数为子痫（75%）。25例（48.1%）患者发生AKI，1期、2期和3期分别占56%、36%和8%。AKI患者的脓毒症发生率（16% vs 0%）、休克发生率（40% vs 7.4%）和贫血发生率（84% vs 59.3%）显著更高（P<0.05）。发生AKI的患者ICU死亡率（28% vs 3.7%）、ICU住院时间和住院时间显著更长（P<0.05）。血清NGAL[274（240 - 335）ng/mL]与AKI或死亡率无相关性（P = 0.725，0.861）；然而，其对子痫有显著的鉴别价值[P = 0.019；曲线下面积 = 0.736（95%置信区间：0.569 - 0.904）]。
尽管AKI在入住ICU的先兆子痫患者中很常见，但血清NGAL不能预测其发生。
Tyagi A, Yadav P, Salhotra R, Das S, Singh PK, Garg D. 入住重症监护病房的重度先兆子痫患者的急性肾损伤：流行病学及血清中性粒细胞明胶酶相关脂质运载蛋白的作用。《印度重症监护医学杂志》2021；25（9）：1013 - 1019。
