Abstract
BackgroundIn a previous study we showed that troponin I (TnI) > 0.42 ng/mL predicted the need of dialysis in a group of 29 septic patients admitted to the intensive care unit (ICU). We aimed to confirm such finding in a larger independent sample.MethodsAll septic patients admitted to an ICU from March 2016 to February 2017 were included if age between 18 and 90 years, onset of sepsis < 24 h, normal left ventricular ejection fraction, and no previous coronary or kidney diseases. TnI was measured on day 1. Patients were followed by 30 days or until death.ResultsA total of 120 patients were included (51% male, 74 ± 13 years old). At ICU admission, 70 patients had TnI > 0.42 ng/mL. These patients had serum creatinine slightly higher (1.66 ± 0.34 vs. 1.32 ± 0.39 mg/dL; P < 0.0001) than those with lower TnI and similar urine output (1490 ± 682 vs. 1406 ± 631 mL; P = 0.44). At the end of the follow-up period, 70.0% of the patients with lower TnI were alive in comparison with 38.6% of those with higher TnI (p = 0.0014). After 30 days, 69.3 and 2.9% of the patients with lower and higher TnI levels remained free of dialysis, respectively (p < 0.0001). In a Cox regression model, after adjustment for gender, age, Charlson comorbidity index, serum creatinine, potassium, pH, brain natriuretic peptide and urine output, TnI > 0.42 ng/mL persisted as a strong predictor of dialysis need (hazard ratio 3.48 [95%CI 1.69–7.18]).ConclusionsTnI levels at ICU admission are a strong independent predictor of dialysis need in sepsis.
Highlights
In a previous study we showed that troponin I (TnI) > 0.42 ng/mL predicted the need of dialysis in a group of 29 septic patients admitted to the intensive care unit (ICU)
We showed the potential of serum troponin I (TnI) to predict a bad kidney outcome in a group of 29 septic patients admitted to the ICU
During the recruitment period, 142 patients were initially enrolled in this study, but 22 of them were excluded
Summary
In a previous study we showed that troponin I (TnI) > 0.42 ng/mL predicted the need of dialysis in a group of 29 septic patients admitted to the intensive care unit (ICU). Sepsis is a highly prevalent syndrome and a major cause of death among hospitalized patients This disorder is currently the main cause of death in non-cardiac intensive care units [1, 2]. Inflammation is a normal response of the body to infection by microbial agents This process can be inappropriately exacerbated, triggering excessive production of inflammatory mediators and activation of. In this context, the identification of early markers of organ dysfunction like AKI would be clinical advantageous in permitting preventive actions that could mitigate the more serious complications of sepsis. Molecules like NGAL, KIM-1 and IL-18 have showed to be able to anticipate AKI [6] Such biomarkers are not currently available in the daily clinical practice
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