Abstract: PO0002
Assessment of a Modified Renal Angina Index for the Prediction of AKI in Hospitalized Adult Patients
Session Information
- AKI Epidemiology, Risk Factors, and Prevention: Clinical Research
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Mariscal-Campos, Ana A., Clinica Los Olivos, Cochabamba, Cochabamba, Bolivia, Plurinational State of
- Claure-Del Granado, Rolando, Clinica Los Olivos, Cochabamba, Bolivia, Plurinational State of
Background
Risk-stratification tools of incident AKI in hospitalized patients are needed. The renal angina index (RAI) was developed and validated in the pediatric population. The purpose of this study was to evaluate the performance of a modified RAI (mRAI) for the prediction of AKI in hospitalized patients.
Methods
We analyzed data from 55 hospitalized patients admitted to our center. Inclusion criteria consisted of age ≥18, hospital stay ≥3 days, at least 2 serum creatinine (SCr) measures in the first 2 days of hospital stay and one measure at 3-7 days of stay. Exclusion criteria consisted of ESKD, kidney transplant or baseline eGFR <15. At admission, mRAI was calculated using the following formula: risk level criteria 1) ICU admission, 2) mechanical ventilation or vasoactive drug support, and 3) diabetes X injury level criteria of SCr increments of <0.1 mg/dL, ≥0.1 mg/dl, ≥0.3 mg/dL and ≥0.4 mg/dL. AKI was defined as an increase of serum creatinine level ≥ 0.3 mg/dL or ≥ 1.5 times within 48 hours or ≥1.5 times in contrast to baseline creatinine level. We assessed the performance of the mRAI to predict the subsequent development of AKI using KDIGO sCr criteria.
Results
Mean (SD) age was 67.9 (13.3), 47.3% were women and 100% Hispanic. The incidence of AKI at 3-7 days of hospital or ICU stay was 52.7%. Most patients developed AKI stage 1 (61.3%) and 38.7% developed severe AKI (KDIGO-SCr stage ≥2) at 3-7 days. Performance metrics are reported in Table. The RAI exhibited a good, AUC of 0.87 (95% confidential interval [CI]: 0.77–0.96; p <0.0001) in ROC analysis, with a cutoff of 8.
Conclusion
The mRAI have robust predictive capacity to identify hospitalized adults patients at high risk of developing AKI. Incorporation of AKI biomarkers into the RAI may potentially improve prediction. The preliminary data of our ongoing study warrants future studies to validate these findings.
Funding
- Private Foundation Support