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Can Serum Nutritional Related Biomarkers Predict Mortality Of Critically Ill Older Patients With Acute Kidney Injury?

Authors Gong Y, Ding F, Gu Y

Received 10 June 2019

Accepted for publication 9 September 2019

Published 18 October 2019 Volume 2019:14 Pages 1763—1769

DOI https://doi.org/10.2147/CIA.S218973

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Bik-Wai Bilvick Tai

Peer reviewer comments 2

Editor who approved publication: Dr Zhi-Ying Wu


Yu Gong,1 Feng Ding,2 Yong Gu2

1Department of Internal Medicine, Division of Nephrology, Shanghai Municipal Eighth People’s Hospital, Shanghai, People’s Republic of China; 2Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China

Correspondence: Yu Gong
Department of Internal Medicine, Division of Nephrology, Shanghai Municipal Eighth People’s Hospital, 8 Caobao Road, Shanghai 200235, People’s Republic of China
Tel +86 21 18930718612
Email gyfd66@126.com

Background: Critically ill older patients with acute kidney injury (AKI), also referred to as acute renal failure, are associated with high in-hospital mortalities. Preexisting malnutrition is highly prevalent among AKI patients and increases in-hospital mortality rate. This study is to evaluate the predictive power of some serum nutritional related biomarkers predicting the 90 days in-hospital mortality of critically ill older patients with AKI.
Methods: A prospective, observational study was conducted in a university teaching hospital. One hundred and five critically ill older patients with AKI aged 60–95 were enrolled and were divided into survival group (n=44) and non-survival group (n=61) in the light of their final outcomes. Receiver operating characteristic analyses (ROC) were performed to calculate the area under ROC curve (AUC). Sensitivity and specificity of in-hospital mortality prediction were calculated.
Results: Significant differences were found between the survival group and non-survival group of critically ill older patients with AKI. AUC of low density lipoprotein (LDL) and albumin were 0.686 and 0.595, respectively. The asymptotic 95% confidence intervals of LDL and albumin were 0.524–0.820 and 0.488–0.696, respectively. Sensitivity of the 90 days in-hospital mortality prediction of LDL and albumin were 68.71% and 69.09%, respectively. Specificity of 90 days in-hospital mortality prediction of LDL and albumin were 69.23% and 50.0%, respectively.
Conclusion: LDL and albumin did not have sufficient power to predict the 90 days in-hospital mortality of critically ill older patients with AKI. Further research on the association between malnutrition and poor prognosis of critically ill older patients with AKI is needed in the future.
Trial registration: ClinicalTrials.gov identifier: NCT00953992.

Keywords: critically ill older patients, acute kidney injury, mortality, nutritional related biomarker

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