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

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
Naoki Yahagi, Toshiro Fujita, Eisei
Noiri
University of Tokyo, Tokyo, Japan,
Itabashi Chuo Medical Center, Tokyo,
Japan
Background: Plasma neutrophil
gelatinase-associated lipocalin (NGAL)
is reportedly useful for pediatric and
adult post-cardiac surgery acute kidney
injury (AKI). However, although chronic
kidney disease (CKD) is a strong risk
factor for AKI development, previous
clinical evaluations did not specifically
examined AKI occurring in patients with
CKD. Moreover, CKD significantly
increases plasma NGAL levels in a
stable condition. Methods: This study
prospectively evaluated 143 adult
patients who had cardiac surgery at two
general hospitals. Plasma NGAL was
measured before surgery, at ICU arrival
after the surgery ( hr), and 2, 4, 12, 24,
36, 6 hr after ICU arrival. Results:
Based on patients’ estimated glomerular
filtration rate (GFR) before surgery, 67
(46.9%) were diagnosed as having CKD.
Of 143 patients, 54 (37.8%) developed
AKI after surgery. Multiple logistic
regression analysis revealed that
preoperative estimated GFR and
operation time were significantly
associated with AKI occurrence after
surgery. Plasma NGAL measured before
surgery and at , 2, 4, 12, 24, and 36 hr
after ICU arrival in AKI was
significantly higher than in non-AKI
regardless of CKD complication.
However, plasma NGAL alone was not
sufficient to discriminate de novo AKI
or AKI superimposed on CKD (Figure).
Receiver operating characteristics
analysis revealed different cutoff values
of AKI for CKD and non-CKD patients.
Conclusions: Plasma NGAL in postcardiac
surgery will predict AKI not
only in non-CKD patients but also in
CKD patients when cutoff values are
determined properly.
38. The ICNARC model is predictive
of hospital mortality in critically ill
patients supported by acute
dialysis
Ying-Jheng Jhuang, Wei-Jie Wang, Vin-
Cent Wu, Tao-Min Huang, Pei-Chen
Wu, Pi-Ru Tsai, Wen-Je Ko, Kuan-Dun
Wu
Division of Nephrology, Department of
Internal Medicine, National Taiwan
University Hospital, Taipei, Taiwan,
Department of Internal Medicine,
Taoyuan General Hospital, Department
of Health, Executive Yuan, Taoyuan,
Taiwan, Department of Traumatology
and Surgery, National Taiwan
University Hospital, Taipei, Taiwan,
Division of Nephrology, Department of
Internal Medicine, Da Chien General
Hospital, Miaoli, Taiwan
Aims: To compare prediction power
between ICNARC model and RIFLE
classification in postoperative patients
receiving acute dialysis. Methods:
Between January 22 and December 28,
529 patients received acute dialysis
during their ICU stay were enrolled.
Patients’ demographic, clinical and
laboratory variables were analyzed as
predictors of mortality. The RIFLE
151