A Simple Scoring Method for Predicting the Low Risk of Persistent Acute Kidney Injury in Critically Ill Adult Patients

• Published in: Scientific reports 2020-03, Vol.10 (1), p.5726-5726, Article 5726
• Main Authors: Matsuura, Ryo, Iwagami, Masao, Moriya, Hidekazu, Ohtake, Takayasu, Hamasaki, Yoshifumi, Nangaku, Masaomi, Doi, Kent, Kobayashi, Shuzo, Noiri, Eisei
• Format: Article
• Language: English
• Subjects: 692/4022/1585/4; 692/53/2423; Acute Kidney Injury - blood; Acute Kidney Injury - complications; Acute Kidney Injury - diagnosis; Aged; Aged, 80 and over; Angina; Angina pectoris; Creatinine; Creatinine - blood; Critical Care; Critical Illness; Female; Hospitals; Humanities and Social Sciences; Humans; Hyperbilirubinemia; Intensive Care Units; Kidney diseases; Male; Medicine; Middle Aged; Models, Theoretical; multidisciplinary; Nephrology; Patients; Pediatrics; Prognosis; Regression analysis; Risk Assessment; Risk factors; Science; Science (multidisciplinary); Sepsis; Sepsis - complications; Transplants & implants; Vasoactive agents; Ventilators
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-62479-w

The renal angina index has been proposed to identify patients at high risk of persistent AKI, based on slight changes in serum creatinine and patient conditions. However, a concise scoring method has only been proposed for pediatric patients, and not for adult patients yet. Here, we developed and validated a concise scoring method using data on patients admitted to ICUs in 21 Japanese hospitals from 2012 to 2014. We randomly assigned to either discovery or validation cohorts, identified the factors significantly associated with persistent AKI using a multivariable logistic regression model in the discovery cohort to establish a scoring system, and assessed the validity of the scoring in the validation cohort using receiver operating characteristic analysis and the calibration slope. Among 8,320 patients admitted to the ICUs, persistent AKI was present in 1,064 (12.8%) patients. In the discovery cohort (n = 4,151), ‘hyperbilirubinemia’, ‘sepsis’ and ‘ventilator and/or vasoactive’ with small changes in serum creatinine were selected to establish the scoring. In the validation cohort (n = 4,169), the predicting model based on this scoring had a c-statistic of 0.79 (95%CI, 0.77–0.81) and was well calibrated. In conclusion, we established a concise scoring method to identify potential patients with persistent AKI, which performed well in the validation cohort.