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Kidney Week

Abstract: PO0032

Urinary Sediment Score Is a Useful Predictor of AKI in Hospitalized Patients

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Heredia-Murillo, Pablo J., Clinica Los Olivos, Cochabamba, Cochabamba, Bolivia, Plurinational State of
  • Claure-Del Granado, Rolando, Universidad Mayor de San Simon Facultad de Medicina, Cochabamba, Cochabamba, Bolivia, Plurinational State of
Background

Risk-stratification tools of incident AKI in hospitalized patients are needed. Early documentation of impaired kidney function through a simple examination like the urinary sediment may provide risk reduction in such patients. The present study aims to explore an association between urinary sediment score described by Perazella et. al. and hospital-acquired AKI.

Methods

This study included 86 patients who underwent urinalysis, including scoring the urinary sediment during the first 24 hour of admission. 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 ml/m/1.73m2. AKI was defined as an increase of serum creatinine level ≥ 0.3 mg/dL or ≥ 1.5 times in contrast to baseline creatinine level within 48 hours. We evaluated if the microscopic examination of the urine sediment (score ≥2) could be use as a non-invasive detector of renal damage.

Results

Mean (SD) age was 65.1 (17.2), 38.4% were women and 100% Hispanic. The incidence of AKI at 3-7 days of hospital or ICU stay was 34.9%. From the 30 patients that developed AKI, 20 were on stage 1 (66.6%), 8 were on stage 2 (26,6%) and 2 were stage 3 (26.6%). Performance metrics of the urinary score used are reported in Table. A urinary sediment score ≥ 2 exhibited a fair, but not good, AUC of 0.681 (95% confidential interval [CI]: 0.554–0.808) in ROC analysis.

Conclusion

Cellular casts and granular casts are occasionally observed in hospitalized adult patients with risk factors for AKI. The urinary sediment score proposed by Perazella el al. could be a potentially useful marker for early documentation of hospital-acquired AKI.

Table: Performance of the urinary sediment score for the prediction of AKI in hospitalized patients

Funding

  • Private Foundation Support