Giuseppa La Camera1, Daniela D'Agati2, Valeria Drago3, Graziano Leonardi3, Matteo Livio La Morella3
rianimazione P.O. biancavilla asp ct - 3Postgraduate School of Anaesthesia and Intensive Care, AOUP Rodolico, University of Catania
Introduction: Acute kidney injury is a widespread problem mainly among critical area patients, therefore it has been necessary to address research towards the identification of biomarkers able to foresee its development and gravity.
Materials and methods: This study, prospective observational unicentric, carried out at the multispecialty Department of Anesthesia and Intensive Care of the "G.Rodolico" Polyclinic Hospital of Catania. , aims to evaluate the utility of biomarkers [TIMP-2]*[IGFBP7]. Urinary measurements were performed using the NephroCheck,ASTUTE 140™, which from the measurement of the two markers directly elaborates the AKI RISK INDEX. The subjects enrolled, 37 adults patients, were subjected to non-cardiac major surgery. A first withdrawal was carried out before the surgery (T0) and a second one 4 hours (T4) after it. Furthermore, a telephonic interview was carried out one month after the surgery, in order to investigate the general health conditions of the patients and any possible return to hospital.
Results: Among the 37 patients, 34 (92%) have not developed acute kidney injury and 3 (8%) manifested KDIGO 1 stage AKI. In 5/37 (13.5%) in which the AKI Risk Index was negative at T0 and became positive at T4 was analyzed the course of pre-operative creatinine, at 24 hours and at 48 hours. The same measurements have been correlated even in patients who had developed acute kidney injury with positive AKI Risk Index both at T0 and T4.
Conclusions: Currently, according to literature data, TIMP-2 and IGFBP7 markers appear to be the most promising in the identification of acute kidney injury at subclinical level. The results we obtained are in line with the literature data, with all the limitations set by the exiguity of the analyzed sample. For this reason, we claim the usefulness of further studies that confirm the effectiveness of biological markers in the early identification of patients at risk of AKI.
biomarkers, AKI, intensive care, early diagnosis.