Alactic base excess predicts the use of renal replacement therapy in patients with septic shock

Renal Replacement Therapy

Research

Fabiola Buelna Gaxiola¹  María V. Calyeca Sánchez¹  Jesús S. Sánchez Díaz¹  Orlando R. Pérez Nieto¹  Karla Gabriela Peniche Moguel¹  José M. Reyes Ruiz² 

[1] Department of Critical Care Medicine, Centro Médico Nacional “Adolfo Ruiz Cortínes”, Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad Hospital de Especialidades No. 14, Avenida Cuauhtémoc S/N Colonia Formando Hogar, C.P 91897, Veracruz, Mexico;Department of Department of Health Research, Centro Médico Nacional, IMSS, Hospital de Especialidades No. 14, Veracruz, Mexico;

关键词: Alactic base excess;    Renal replacement therapy;    Septic shock;    Acute kidney injury;   

DOI  :  10.1186/s41100-023-00494-z

 received in 2023-02-24, accepted in 2023-07-28,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAlactic base excess (ABE) is a novel biomarker that estimates the renal capability of handling acid–base alterations during the sepsis. Hence, the aim of this study was to evaluate the use of ABE to predict the renal replacement therapy (RRT) in patients with septic shock.MethodsA total of 164 patients admitted to the intensive care units with a diagnosis of septic shock according to the third international consensus on sepsis and septic shock (Sepsis-3) were included. This study was retrospective, single center, and conducted between January 1, 2016, and December 31, 2020. The individuals were stratified in patients who did [n = 68] or did not [n = 96] receive the RRT. The diagnostic performed of the variables for the classification into patients who required RRT was evaluated by receiver operating characteristic (ROC) analysis and area under curve (AUC) was calculated. Univariate and multivariate logistic regression models were used to identify risk factors for RRT.ResultsThe median age of the patients was 59 years and female sex (51.8%) predominated. ABE (odds ratio [OR] 1.2270, [95% confidence interval [CI] 1.0453–1.4403], p = 0.0124) and urea (OR 1.0114, [95% CI 1.0053–1.0176], p = 0.0002) were associated with risk of RRT. HCO3− (OR 0.6967, [95% CI 0.5771–0.8410], p = 0.0002) was a protective factor of RRT. ABE (AUC = 0.649, p < 0.0008), HCO3− (AUC = 0.729, p < 0.0001), and urea (AUC = 0.76, p < 0.0001) had a cutoff point of ≤ − 5.7 mmol/L, ≤ 19.36 mmol/L and > 75 mg/dL, respectively.ConclusionAlthough HCO3− is associated with low risk, ABE and urea are independent risk factors for RRT in the patients with septic shock.

【 授权许可】

CC BY   
© The Japanese Society for Dialysis Therapy and BioMed Central Ltd. 2023

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