tailieunhanh - Báo cáo y học: "Urinary cystatin C is diagnostic of acute kidney injury and sepsis, and predicts mortality in the intensive care unit"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Urinary cystatin C is diagnostic of acute kidney injury and sepsis, and predicts mortality in the intensive care unit. | Nejat et al. Critical Care 2010 14 R85 http content 14 3 R85 RESEARCH Open Access Urinary cystatin C is diagnostic of acute kidney injury and sepsis and predicts mortality in the intensive care unit Maryam Nejat 1 John W Pickering1 Robert J Walker2 Justin Westhuyzen1 Geoffrey M Shaw1 3 Christopher M Frampton1 and Zoltán H Endre 1 Abstract Introduction To evaluate the utility of urinary cystatin C uCysC as a diagnostic marker of acute kidney injury AKI and sepsis and predictor of mortality in critically ill patients. Methods This was a two-center prospective AKI observational study and post hoc sepsis subgroup analysis of 444 general intensive care unit ICU patients. uCysC and plasma creatinine were measured at entry to the ICU. AKI was defined as a 50 or dL increase in plasma creatinine above baseline. Sepsis was defined clinically. Mortality data were collected up to 30 days. The diagnostic and predictive performances of uCysC were assessed from the area under the receiver operator characteristic curve AUC and the odds ratio OR . Multivariate logistic regression was used to adjust for covariates. Results Eighty-one 18 patients had sepsis 198 45 had AKI and 64 14 died within 30 days. AUCs for diagnosis by using uCysC were as follows sepsis 95 confidence interval CI to AKI CI to and death within 30 days CI to . After adjustment for covariates uCysC remained independently associated with sepsis AKI and mortality with odds ratios CI of to to and to respectively. Concentrations of uCysC were significantly higher in the presence of sepsis P or AKI P . No interaction was found between sepsis and AKI on the uCysC concentrations P . Conclusions Urinary cystatin C was independently associated with AKI sepsis and death within 30 days. Trial registration Australian New Zealand Clinical Trials Registry ACTRN012606000032550. Introduction AKI is a .