ABSTRACTS CRITICARE – IJCCM2021

Abstract

IntroductionCritically ill preeclamptic patients may have risk factors for acute kidney injury (AKI). Neutrophil gelatinase-associated lipocalcin (NGAL) is a validated biomarker to predict AKI. We could locate scanty data regarding the epidemiology of AKI and the role of NGAL in preeclamptic patients admitted to ICU.Materials and methodsPreeclamptic patients admitted to multidisciplinary ICU were included. The occurrence of AKI and its severity for the entire ICU stay using KDIGO criteria, risk factors, and serum NGAL were assessed.ResultsFrom 52 preeclamptic patients admitted to ICU, majority had eclampsia (75%). The ICU mortality was 15.4%. AKI developed in 25 (48.1%) patients; with stage 1, 2 and 3 in 56%, 36% and 8% respectively. Incidence of sepsis (16% versus 0%), shock (40% versus 7.4%), and anaemia (84% versus 59.3%) was significantly greater in patients with AKI (P < 0.05). ICU mortality (28% versus 3.7%), duration of ICU and hospital stay were significantly higher in preeclamptics with AKI (P < 0.05). Serum NGAL (274 [240-335] ng/ml) showed no association with AKI or mortality (P = 0.725, 0.861); but significant prediction for eclampsia [P = 0.019; AUC = 0.736 (95% CI: 0.569 – 0.904)].DiscussionsThe present prospective cohort study aimed to evaluate AKI in a specific subset of critically ill obstetric patients viz., those with preeclampsia. While there is little previous data on AKI in critically ill preeclamptic patients, it has been evaluated among those with the disease but not admitted to ICU.11–13 The incidences herein were reported in a lower percentage than our results viz., 15.3 and 17%.11,12 The much greater incidence noted by us can be attributed to an increased presence of risk factors for AKI encountered in those admitted to the ICU, such as, sepsis and shock.ConclusionAKI is common among preeclamptic patients admitted to ICU, but serum NGAL does not predict AKI in these patients.