Predictors of Severe Outcomes in In-Hospital AKI

The rates of in-hospital AKI are increasing; patients who develop AKI are at risk for a poor prognosis. There are emerging biomarkers that may help identify early stages of AKI; however, accurate prediction of severe outcomes, such as the need for kidney replacement therapy (KRT), remains challenging.  

According to Rebecca Lehmann, MD, and colleagues, blood gas analyses (BGA) are useful in diagnosing life-threatening complications associated with AKI. The researchers conducted a study designed to assess the role of BGA as a biomarker panel in emerging and established cases of AKI. 

The retrospective, observational study included 202 patients with newly developed AKI to document venous and arterial pH, pCO2, and actual bicarbonate levels at baseline (hospital admission) and at the onset of AKI. The primary end points of interest were in-hospital mortality, the need for KRT, and the recovery of kidney function. 

Among the 202 participants, three variables were independent predictors of in-hospital survival: (1) admission arterial pH; (2) arterial pH at onset of AKI; and (3) arterial pCO2 at onset of AKI. In addition, venous pCO2 at AKI onset was identified as an independent predictor for the need of KRT. 

“Our study suggests that blood gas analysis may have a potential role in predicting severe outcome variables in AKI,” the researchers said. “The associated costs are minimal.” 

Source: BMC Nephrology