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|Title:||The incidence, characteristics, outcomes and associations of small short-term point-of-care creatinine increases in critically ill patients.|
|Authors:||Toh, Lisa;Bitker, Laurent;Eastwood, Glenn M;Bellomo, Rinaldo|
|Affiliation:||Université de Lyon, CREATIS CNRS UMR5220 INSERM U1044 INSA, Lyon, France..|
School of Medicine, The University of Melbourne, Melbourne, Australia
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Data Analytics Research and Evaluation (DARE) Centre, Austin Health and The University of Melbourne, Heidelberg, Victoria, Australia
|Citation:||Journal of Critical Care 2019; 52: 227-232|
|Abstract:||We assessed the incidence, characteristics, outcomes and associations of small, short-term point-of-care creatinine increases in critically ill patients. We prospectively identified the first episode of small (>1 μmol/L/h) short-term (3-4 h) point-of-care creatinine increase between two sequential arterial blood gas measurements. We followed patients for the subsequent development of Kidney Disease: Improving Global Outcomes (KDIGO) defined acute kidney injury (AKI) in the intensive care unit (ICU). Of 387 patients, 279 (72.1%) developed an episode of small short-term point-of-care creatinine increase and 212 (54.8%) developed AKI. Such episodes occurred at a median of 5 (IQR 2-10) hours after ICU admission, while AKI occurred at a median of 15 (IQR 9-28) hours after admission. Patients with such episodes were more likely to be mechanically ventilated on admission (83.9 vs. 44.4%; p < .001) and had higher hospital mortality (10.9 vs. 3.7%, p = .03). Creatinine increase episodes had a sensitivity of 86% (95% CI 78-95) and specificity of 31% (95% CI 26-36) for subsequent AKI stages 2 and 3 in 24 h. Small, short-term point-of-care creatinine increase episodes are common. They are associated with illness severity, occur early, precede AKI by 10 h and are sensitive rather than specific markers of AKI.|
|Subjects:||Acute kidney injury|
Intensive care unit
|Appears in Collections:||Journal articles|
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