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Annals of Clinical and Laboratory Research

ISSN - 2386-5180

Research Article - (2019) Volume 7, Issue 1

Are Albumin and Lactate Predictive Indicators for Mortality in Critically Ill Patients with Acute Kidney Injury?

 

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Abstract

Introduction: The aim of this study was to assess the effect of age, gender, estimated glomerular filtration rate, albumin and lactate on mortality on critically ill patients admitted to intensive care unit due to acute kidney injury.

Methods: The study included 54 critically ill patients over the age of 18, who were admitted to our Level 3 intensive care unit with the diagnosis of acute kidney injury. Patients were divided into two groups as those who did not develop mortality (Group 1) and those who developed (Group 2). Both groups were compared in terms of age, gender, estimated glomerular filtration rate, albumin and lactate levels in the first 24 hours of admission. In addition, patients were divided into two groups according to both albumin levels (<2.5 g/dL and ≥2.5 g/dL) and lactate levels (<2 mmol/L and ≥2 mmol/L) and examined in terms of 30-day mortality.

Results: The patients’ total mortality was 68.5% (37 patients). There was no statistically significant difference between the two groups (Group 1 and Group 2) in terms of age, sex, estimated glomerular filtration rate, albumin and lactate levels (p-values, respectively: 0.13; 0.39; 0.32; 0.83; 0.52). In addition, there was no statistically significant difference between the groups in terms of 30- day mortality (p-values: 0.625; 0.127).

Conclusion: Age, gender, estimated glomerular filtration rate, albumin and lactate levels did not affect 30-day and total mortality in our patients who were hospitalized in our intensive care unit with acute kidney injury diagnosis, and that albumin and lactate levels during admission were not a predictor of mortality in this patient group.

References

  1. Yu MY, Lee SW, Baek SH (2017) Hypoalbuminemia at admission predicts the development of acute kidney injury in hospitalized patients: A retrospective cohort study. PLoS One 12 e0180750.
  2. Wiedermann CJ, Wiedermann W, Joannidis M (2010) Hypoalbuminemia and acute kidney injury: A meta-analysis of observational clinical studies. Intensive Care Med 36:1657-1665.
  3. Thongprayoon C, Cheungpasitporn W, Mao MA (2018) U-shape association of serum albumin level and acute kidney injury risk in hospitalized patients. PLoS One 13: 1-12.
  4. Echeverri J, Gonzalez CA, Rodriguez P (2018) Early mortality risk factors at the beginning of continuous renal replacement therapy for acute kidney injury. Cogent Med 5: 1-7.
  5. Tiwari S, Agarwal SK, Mahajan S (2006) Spectrum of Acute Renal Failure and Factors Predicting Its Outcome in an Intensive Care Unit in India. Ren Fail 28: 119-124.
  6. Jellinge ME, Henriksen DP, Hallas P (2014) Hypoalbuminemia is a strong predictor of 30-day all-cause mortality in acutely admitted medical patients: A prospective, observational, cohort study. PLoS One 9: 8-12.
  7. Touma E, Bisharat N (2019) Trends in admission serum albumin and mortality in patients with hospital readmission. Int J Clin Pract e13314.
  8. Wu CY, Hu HY, Huang N (2018) Albumin levels and cause-specific mortality in community-dwelling older adults. Prev Med (Baltim) 112: 145-151.
  9. Wada H, Dohi T, Miyauchi K (2018) Long-term clinical impact of serum albumin in coronary artery disease patients with preserved renal function. Nutr Metab Cardiovasc Dis 28: 285-290.
  10. Eisen A, Haim M, Hoshen M (2017) Estimated glomerular filtration rate within the normal or mildly impaired range and incident non-valvular atrial fibrillation: Results from a population-based cohort study. Eur J Prev Cardiol 24: 213-222.
  11. Cai M, Shan P, Xie Q (2018) Association between admission lactate levels and mortality in patients with acute coronary syndrome. Coron Artery Dis 30: 26-32.
  12. Hsu YC, Hsu CW (2019) Septic acute kidney injury patients in emergency department: The risk factors and its correlation to serum lactate. Am J Emerg Med 37: 204-208.
  13. Sun DQ, Zheng CF, Bin LF (2018) Serum lactate level accurately predicts mortality in critically ill patients with cirrhosis with acute kidney injury. Eur J Gastroenterol Hepatol 30: 1361-1367.
  14. Rishu AH, Khan R, Al-Dorzi HM (2013) Even mild hyperlactatemia is associated with increased mortality in critically ill patients. Crit Care 17: 197.
  15. Rhodes A, Evans LE, Alhazzani W (2016) Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Crit Care Med 45: 486-552.
  16. Kawarazaki H, Uchino S, Tokuhira N (2013) Who may not benefit from continuous renal replacement therapy in acute kidney injury? Hemodial Int 17: 624-632.
  17. Saxena A, Meshram S (2018) Predictors of mortality in acute kidney injury patients admitted to medicine intensive care unit in a Rural Tertiary Care Hospital. Indian J Crit Care Med 22: 231-237.
  18. Oluseyi A, Ayodeji A, Ayodeji F (2016) Aetiologies and Short-term Outcomes of Acute Kidney Injury in a Tertiary Centre in Southwest Nigeria. Ethiop J Health Sci 26: 37–44.
  19. Poukkanen M, Vaara ST, Reinikainen M (2015) Predicting one-year mortality of critically ill patients with early acute kidney injury: Data from the prospective multicenter Finnaki study. Crit Care 19: 9-15.
  20. Shiao CC, Ko WJ, Wu VC (2012) U-Curve association between timing of renal replacement therapy initiation and in-hospital mortality in postoperative acute kidney injury. Burdmann EA, ed. PLoS One 7: e42952.
  21. Emem-Chioma PC, Alasia DD, Wokoma FS (2012) Clinical outcomes of dialysis-treated acute kidney injury patients at the University of Port Harcourt Teaching Hospital, Nigeria. ISRN Nephrol 1-6.
  22. Bagasha P, Nakwagala F, Kwizera A (2015) Acute kidney injury among adult patients with sepsis in a low-income country: Clinical patterns and short-term outcomes Epidemiology and Health Outcomes. BMC Nephrol 16: 1-7.
  23. Effa EE, Okpa HO, Mbu PN (2015) Acute kidney injury in hospitalized patients at the University of Calabar Teaching Hospital?: An aetiological and outcome study. IOSR Journal of Dental and Medical Sciences 14: 55-59.
  24. Hamzi?-Mehmedbaši? A, Raši? S, Rebi? D (2016) Prognostic indicators of adverse renal outcome and death in acute kidney injury hospital survivors. J Ren Inj Prev 5: 61-68.
  25. Arnau-Barrés I, Güerri-Fernández R, Luque S (2019) Serum albumin is a strong predictor of sepsis outcome in elderly patients. Eur J Clin Microbiol Infect Dis 24.
  26. Famakin B, Weiss P, Hertzberg V (2010) Hypoalbuminemia predicts acute stroke mortality: Paul Coverdell Georgia Stroke Registry. J Stroke Cerebrovasc Dis 19: 17-22.
  27. Plakht Y, Gilutz H, Shiyovich A (2016) Decreased admission serum albumin level is an independent predictor of long-term mortality in hospital survivors of acute myocardial infarction. Soroka Acute Myocardial Infarction II (SAMI-II) project. Int J Cardiol 219: 20-24.
  28. Pizzonia M, Razzano M, Palummeri E (2013) Predictors of mortality after hip fracture: results from 1-year follow-up. Aging Clin Exp Res 18: 381-387.
  29. Ñamendys-Silva SA, González-Herrera MO, Texcocano-Becerra J (2011) Hypoalbuminemia in critically ill patients with cancer: Incidence and mortality. Am J Hosp Palliat Med 28: 253-257.
  30. Lyons O, Whelan B, Bennett K (2010) Serum albumin as an outcome predictor in hospital emergency medical admissions. Eur J Intern Med 21: 17-20.
  31. Liu M, Chan CP, Yan BP (2012) Albumin levels predict survival in patients with heart failure and preserved ejection fraction. Eur J Heart Fail 14: 39-44.
  32. Salottolo KM, Mains CW, Offner PJ (2013) A retrospective analysis of geriatric trauma patients: Venous lactate is a better predictor of mortality than traditional vital signs. Scand J Trauma Resusc Emerg Med 21: 1.
  33. Neville AL, Nemtsev D, Manasrah R (2011) Mortality risk stratification in elderly trauma patients based on initial arterial lactate and base deficit levels. Am Surg 77: 1337-1341.
  34. Jonsson MH, Hommel A, Turkiewicz A (2018) Plasma lactate at admission does not predict mortality and complications in hip fracture patients: a prospective observational study. Scand J Clin Lab Invest 78: 508-514.
  35. Coats TJ, Uzoigwe CE, Balasubramanian S (2015) Serum lactate as a marker of mortality in patients with hip fracture: A prospective study. Injury 46: 2201-2205.
  36. Uzoigwe CE, Venkatesan M, Smith R (2012) Serum lactate is a prognostic indicator in patients with hip fracture. HIP Int 22: 580-584.
  37. Singer M, Deutschman CS, Seymour C (2016) The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA - J Am Med Assoc 315: 801-810.
  38. Shankar-Hari M, Phillips GS, Levy ML (2016) Developing a new definition and assessing new clinical criteria for septic shock: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA 315: 775-787.
  39. Haas SA, Lange T, Saugel B (2016) Severe hyperlactatemia, lactate clearance and mortality in unselected critically ill patients. Intensive Care Med 42: 202-210.
  40. Masyuk M, Wernly B, Lichtenauer M (2019) Prognostic relevance of serum lactate kinetics in critically ill patients. Intensive Care Med 45: 55-61.
  41. Van Den Nouland DPA, Brouwers MCGJ, Stassen PM (2017) Prognostic value of plasma lactate levels in a retrospective cohort presenting at a University Hospital Emergency Department. BMJ Open 7: e011450.

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