ABSTRACTS from 16th International COnference on ... - CRRT Online

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
p-RIFLE at 72hrs allow to predict
mortality at PICU.
36. Creatinine Production and
Creatinine Degradation are
Reduce in Patients with Acute
Kidney Injury and Sepsis
Rolando Claure-Del Granado, Josee
Bouchard, Sharon Soroko, Glenn M
Chertow, Jonathan Himmelfarb, Alp T
Ikizler, Emil P Paganini, Ravindra L
Mehta
University of California San Diego,
University of Montreal, Stanford
University, University of Washington,
Vanderbilt University, Cleveland Clinic
Background: Diagnosis and staging of
acute kidney injury (AKI) uses serum
creatinine (sCr). In a previous animal
model of AKI, Doi et al have shown that
sepsis dramatically decreases sCr levels
and creatinine production. This
phenomenon would limit early detection
of acute kidney injury. We evaluated the
effect of sepsis on sCr levels, creatinine
production (Pc’), and creatinine
degradation (Dc’) in patients with AKI.
We hypothesized that sepsis will reduce
creatinine production and sCr levels in
AKI patients with sepsis.
Methods: We analyzed data <strong>from</strong> 234
critically ill non-dialyzed patients with
AKI <strong>from</strong> 5 centers included in the
PICARD study. Creatinine production
was calculated using Cockcroft-Gault
formula and using Moran et al formula
which adjusts sCr for fluid balance.
Creatinine degradation was computed
using Mitch et al equation and adjusted
for fluid balance. Results: Of the 234
patients 139 were septic (59%). Nonadjusted
and adjusted sCr levels were
lower in AKI patients with sepsis than in
non-septic patients (non-adjusted sCr
median 2. IQR [1.5 – 2.8] vs. 2.5 IQR
[1.8 – 3.5] and adjusted sCr 2. IQR [1.4
– 2.7] vs 2.4 IQR [1.8 – 3.6]; p < .1). Pc’
was lower in septic patients than in nonseptic
(1,211 IQR [934 – 1,472] vs.
1,278 IQR [1.17 – 1,538] mg/day; p <
.1); the same was observed after
adjusting Pc’ for fluid balance (1,92 IQR
[828 – 1,295] vs. 1,124 IQR [892 –
1,344]; p < .1). Dc’ was also
significantly lower in septic than in nonseptic
patients [Figure 1]. Conclusions:
Sepsis reduces creatinine production and
reduces sCr levels in critically-ill
patients with AKI. These observations
could limit the early diagnosis of AKI.
Sepsis also affects creatinine
degradation.
37. AKI Superimposed On CKD After
Cardiac Surgery Needs Different
Cutoff Value Of Plasma NGAL
Kent Doi, Masahiro Urata, Daisuke
Katagiri, Seiichiro Murata, Minoru Ono,
150