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Abstract: SA-PO070

Validation of ISN 0by25 Acute Kidney Injury Risk Score for Low- and Low Middle-Income Countries

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Claure-Del Granado, Rolando, Universidad Mayor de San Simon Facultad de Medicina, Cochabamba, Bolivia, Plurinational State of
  • Calatayud Rosso, Fabiana M., Clinica Los Olivos, Cochabamba, Bolivia, Plurinational State of
  • Yang, Jason W., University of California San Diego School of Medicine, La Jolla, California, United States
  • Lee, Pei Lun, University of California San Diego School of Medicine, La Jolla, California, United States
  • Zhang, Jingyao, University of California San Diego School of Medicine, La Jolla, California, United States
  • Malhotra, Rakesh, University of California San Diego School of Medicine, La Jolla, California, United States
Background

Incidence of Acute Kidney Injury (AKI) is increasing in low-resource countries and is associated with morbidity and mortality. Early identification of patients at increased risk for AKI is the first step to implement preventive and treatment strategies. Multiple risk scores to predict AKI have been developed in higher-income countries and are specific for particular risk settings. Here, we validated new symptoms-based ISN 0by25 AKI risk score that can be easily implementable in resource-constrained environments.

Methods

Forty-seven hospitalized patients from Clinica “Los Olivos” in Cochabamba, Bolivia were enrolled in this ongoing study. Data for predictor variables was extracted from patient’s medical charts at the time of admission. The ISN 0by25 risk score was calculated at admission and patients with a risk score of ≥ 3 points were included. Patient information was recorded from the time of diagnosis and renal function (serum creatinine[sCr]) was followed up daily up to 7 days. AKI was defined using KDIGO sCr criteria.

Results

A total of 29 patients (61.7%) developed AKI and 77% were female. The main risk factors for AKI were age ≥65 years (64%), DM (60%) and congestive heart failure (40%). The 3 main causes of AKI were nephrotoxins exposure (93.6%), dehydration (87.2%), and hypotension (38.2%). Positive and negative predictive values for the optimal cutoff value of ≥ 6 points in the cohort were 87.5% and 65.2% respectively with an odds ratio (OR) of 13.1 (95% CI 3.0-57.8; p=0.0007). The risk score has a good performance in predicting AKI with a ROC-AUC of 0.85 (95% CI 0.75 - 0.96; p = 0.0001). None of the patients who developed AKI required dialysis.

Conclusion

We validated the performance of the ISN 0by25 risk score in predicting hospital-acquired AKI, which showed good performance. This risk assessment tool could help clinicians stratify patients for primary prevention, surveillance and early therapeutic interventions to improve the care and outcomes of high-risk patients in low-resource settings.