SAN DIEGO — Research presented at ASN Kidney Week showed that stratified data observing AKI risk factors can allow doctors to better predict RRT as well as renal function recovery.
“I think in this moment we don't have any real effective treatment for renal replacement for those patients who develop acute kidney injury,” said Priscila B. Villalvazo, IMSS, Zapopan, Jaliscco, Mexico. “It's important to learn to identify those risk factors for all the patients that are admitted to hospitals because they are at risk of developing it, and just the fact that they have it will increase their morbidity and mortality.”
In a single center cohort study of 112 Mexican patients with a mean age of 56.81 ± 18.38 years, researchers used serum creatinine assay to diagnose patients with AKI. Primary outcomes included renal recovery, mortality and cause of death.
“We found a global mortality of 48% of the patients and we found that those patients with high serum creatinine and with a higher fluid balance were at higher risk of needing renal replacement therapy,” Villalvazo said. “Although we only had 11 patients who had a furosemide test, those patients with the response to that test were the patients with a higher factor for renal recovery.”
Of the patients in the cohort, AKI stage 3, mixed causes and pre-renal AKI were the most common types of AKI. The main etiologies included cardiovascular disease, at 30%, and sepsis at 24%.
Researchers found that of the 112 patients, 49% initiated RRT and 55% saw renal recovery, and they observed statistically significant differences in serum creatinine admission and fluid balance as risk factors for RRT as well as furosemide response as a factor in renal recovery.
“[We] can see how the patients that received dialysis, like the first treatment where those patients who had a high survival,” Villalvazo said. “We see that those with lowest survival, where the patients with conservative initial treatment or those with continuous renal replacement therapy, it could be because in their follow up. Some of the conservative patients had clinical deterioration. So, they needed renal replacement therapy, but it was impossible to give them some kind of therapy because of their more dynamic conditions.” – by Kristine Houck, MA, ELS, and Scott Buzby.
Villalvazo P, et al. Paper SA-PO535. Presented at: ASN Kidney Week; San Diego; Oct. 23-28, 2018.
Disclosure: Villalvazo reports the study received non-U.S. government support and no other financial disclosures.