Myo-Inositol Oxygenase as a Predictor of Acute Kidney Injury in Critically ill Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hayem M Aref ◽  
Haitham Ezzat ◽  
Hussein S Hussein ◽  
Mona E Asaad
Keyword(s):  
Acute Kidney Injury ◽  
Early Diagnosis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Control Group ◽  
Specific Enzyme ◽  
Diagnostic Sensitivity And Specificity ◽  
Time Of Admission ◽  
Potential Use

Abstract Background Acute kidney injury (AKI) affects 45% of critically ill patients, resulting in increased morbidity and mortality. The diagnostic standard, plasma creatinine, is nonspecific and may not increase until days after injury. Aim of the work to assess myo inositol oxygenase as noval marker in early detection of acute kidney injury critically ill patients. Patients and Methods In this prospective study, 40 critically ill patients were followed up in ICU up regarding development of Aki in ICU according to KDIGO definition. They were categorized into two subgroups; 20 patients developed AKI in and 20 patients who did not develop AKI. In addition, a control group of 20 individuals in Ain Shams Hospital during the period from 2018 to 2019, we did myoinositol oxygenase level test at time of admission and repeated in patients group which develop AKI within 24-48 hours. Results MIOX for the diagnosis of AKI When the cut-off value was taken as above 800, the diagnostic sensitivity and specificity of MIOX for AKI were 100%). For creatinine, at the cut-off value of above 0.9, the sensitivity for AKI were found 90% and specificity for AKI were found 65%. Conclusion The measurement of serum MIOX is valuable for the diagnosis of AKI. Further research is needed for the evaluation of the potential use of MIOX as a kidney-specific enzyme in the early diagnosis of AKI.

scholarly journals Evaluation of the risk of acute kidney injury with the use of piperacillin/tazobactam among adult critically ill patients

Infection ◽  
2020 ◽  
Vol 48 (5) ◽  
pp. 741-747 ◽  
Author(s):  
Mohamed O. Saad ◽  
Adham M. Mohamed ◽  
Hassan A. Mitwally ◽  
Ahmed A. Shible ◽  
Ali Ait Hssain ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Primary Outcome ◽  
Kidney Injury ◽  
Outcome Analysis ◽  
Control Group ◽  
Multiple Logistic Regression ◽  
Increased Risk ◽  
Medical Intensive Care

Abstract Purpose Piperacillin/tazobactam (PT), when combined with vancomycin, is associated with an increased risk of acute kidney injury (AKI). It is not known whether PT alone is associated with a higher incidence of AKI compared to other β-lactams among critically ill patients. The objective of this study was to compare the incidence of AKI associated with the use of PT to other β-lactams among adult critically ill patients Methods This retrospective study was conducted in the surgical and the medical intensive care units at two hospitals within Hamad Medical Corporation (HMC) in Qatar and included adult critically ill patients who received at least one dose of anti-pseudomonal β-lactams. The primary outcome was acute kidney injury, defined using the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Multiple logistic regression with adjustment for pre-specified potential confounders was used for the primary outcome analysis. Results A total of 669 patients were included in the analysis: 507 patients in the PT group and 162 patients in the control (meropenem/cefepime) group. AKI occurred in 136 (26.8%) members of the PT group and 38 (23.5%) members of the control group [odds ratio (OR) 1.2; 95% confidence interval (CI) 0.79–1.8]. The results were not significantly altered after adjusting for the pre-specified potential confounders (adjusted OR 1.38; 95% CI 0.88–2.15). Conclusion In this study, PT was not associated with a higher risk of AKI compared to cefepime or meropenem among adult critically ill patients.

Early diagnosis of acute kidney injury by urinary YKL-40 in critically ill patients in ICU: a pilot study

2020 ◽  
Vol 52 (2) ◽  
pp. 351-361 ◽  
Author(s):  
Eman Salah Albeltagy ◽  
Abeer Mohammed Abdul-Mohymen ◽  
Doaa Refaat Amin Taha
Keyword(s):  
Acute Kidney Injury ◽  
Pilot Study ◽  
Early Diagnosis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury

scholarly journals Plasma Neutrophil Gelatinase Associated Lipocalin (NGAL) – Early Biomarker for Acute Kidney Injury in Critically Ill Patients

2015 ◽  
Vol 1 (4) ◽  
pp. 154-161 ◽  
Author(s):  
Grigorescu Bianca ◽  
Fodor Raluca ◽  
Mihaly Veres ◽  
Monica Orlandea ◽  
Judita Badea ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Early Diagnosis ◽  
Creatinine Clearance ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Likelihood Ratios ◽  
Roc Curve Analysis ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

Abstract Introduction: NGAL (Neutrophil Gelatinase Associated Lipocalin) is a biomarker recently introduced into clinical practice for the early diagnosis of acute kidney injury (AKI). The aim of this study was to correlate the plasmatic NGAL value determined at admission with clinical progression and severity of AKI in critically ill patients. Material and method: Thirty two consecutive critically ill adult patients at risk of developing AKI (trauma, sepsis), admitted in Intensive Care Unit of the Clinical County Emergency Hospital Mures, between January to March 2015 were enrolled in the study. For each patient included in the study plasma NGAL levels were determined on admission, and these were correlated with the degree of AKI development (according to AKIN criteria) at 48 hours and 5 days post admission. The discriminatory power of NGAL, creatinine, creatinine clearance and corrected creatinine (depending on water balance) were determined using the ROC (receiver-operating characteristic) and likelihood ratios. Results: ROC curve analysis showed a better discriminatory capacity in terms of early diagnosis of AKI for NGAL (AUC=0.81 for NGAL, AUC=0.59 for creatinine, AUC=0.62 for corrected creatinine, AUC=0.29 for creatinine clearance). The value of likelihood ratio was also significantly higher for NGAL (3.01±2.73 for NGAL, 1.27±1.14 for creatinine, 1.78±1.81 for corrected creatinine, and 0.48±0.33 for creatinine clearance). Conclusions: NGAL biomarker has a better discrimination capacity for early prediction of acute kidney injury compared to previously used markers.

scholarly journals The Use of Plasma and Urine Neutrophil Gelatinase Associated Lipocalin (NGAL) and Cystatin C in Early Diagnosis of Septic Acute Kidney Injury in Critically Ill Patients

2013 ◽  
Vol 34 (4) ◽  
pp. 237-246 ◽  
Author(s):  
Müge Aydoğdu ◽  
Gül Gürsel ◽  
Banu Sancak ◽  
Serpil Yeni ◽  
Gülçin Sarı ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Early Diagnosis ◽  
Critically Ill ◽  
Cystatin C ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Urinary Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Septic Acute Kidney Injury ◽  
Neutrophil Gelatinase

Aim: To assess and compare the roles of plasma and urine concentrations of neutrophil gelatinase associated lipocalin (NGAL) and Cystatin C for early diagnosis of septic acute kidney injury (AKI) in adult critically ill patients.Methods: Patients were divided into three groups as sepsis-non AKI, sepsis-AKI and non sepsis-non AKI. Plasma samples for NGAL and Cystatin C were determined on admission and on alternate days and urinary samples were collected for every day until ICU discharge.Results: One hundred fifty one patients were studied; 66 in sepsis-non AKI, 63 in sepsis-AKI, 22 in non-sepsis-non-AKI groups. Although plasma NGAL performed less well (AUC 0.44), urinary NGAL showed significant discrimination for AKI diagnosis (AUC 0.80) with a threshold value of 29.5 ng/ml (88% sensitivity, 73% specificity). Both plasma and urine Cystatin C worked well for the diagnosis of AKI (AUC 0.82 and 0.86, thresholds 1.5 and 0.106 mg/L respectively).Conclusion: Plasma and urinary Cystatin C and urinary NGAL are useful markers in predicting AKI in septic critically ill patients. Plasma NGAL raises in patients with sepsis in the absence of AKI and should be used with caution as a marker of AKI in septic ICU patients.

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