Abstract: FR-PO0418
Ulinastatin and AKI: Is It the Answer We Are Looking For?
Session Information
- AKI: Biomarkers, Diagnostics, and Risk Prediction
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Author
- Gupta, Sonia, Kidney Care Hospital & Research Center, Udaipur, India
Background
In critically ill patients with AKI, unacceptably high mortality rates reaching up to 50-80% in all dialyzed ICU patients are seen despite the availability of intensive renal support. At present there is no specific or targeted therapy for AKI. Delayed referrals, tendency to try indigenous therapies and poor awareness about the disease add to the burden.1 out of 4 patients who develop severe sepsis will die during hospitalization in the best of the centers.
Ulinastatin is a multifunctional Kunitz type serine protease inhibitor .Our premise regarding the use of molecule in AKI was based on the fact that this molecule acts at multiple levels in the sepsis and can act to stop the cascade and thereby stop the “storm”.
Methods
We studied a total of 528 patients with AKI who needed ICU care in our hospital in the period between January 2022 to February 2026. Out of these, 264 patients received Injection Ulinastatin (1.5mu) 3 doses a day for 5 days, against a similar number of control patients. We included those patients with AKI who had SOFA scores more than 8. None of the patients had COVID 19 infection. All the patients included had received dialytic therapy. The age of the patients varied from 11-94 years (mean age 52 years), The etiologies were as follows: Malaria – complicated – P vivax, P falciparum (n= 200) 38%, Enteric fever (n= 84) 16%, UTI (n=100) 19%, Post partum (n=52) 10%, Dengue (n = 37) 7%, non enteric acute gastroenteritis/diarrhoeal diseases (n=32) 6%, Pancreatitis (n=21) 4%, Obstructive uropathy , 33 % ( n=174) patients had diabetes as a co morbid condition.
Apart from blood tests we recorded the length of stay, need and duration of renal replacement therapy, time to stoppage of renal replacement therapy, need for mechanical ventilation, mortality and post AKI recovery and progression to CKD.
Results
The patients who received ulinastatin had a shorter stay in the ICU (p <0.01 vs control group); also the time to stoppage of renal replacement therapy was shorter (p < 0.05). . The progression to CKD was seen in 11% (n= 29 ) in ulinastatin group, while in control group 13.8 % (n=36), of patients . .The overall mortality was 41 %( n=216).
Conclusion
In developing countries where AKI is a burden - something which is not detected as early as it should be, ulinastatin shows promise. It can be of great help and can possibly alter the outcomes. Large scale or multicenter double blind trials can show the way .