For a study, researchers sought to assess the predictive value of short-term creatinine alterations for acute kidney injury (AKI) when used alone and in conjunction with other AKI risk variables. For this prospective cohort study, all creatinine values were derived from regular point-of-care arterial blood gas measurements taken from ICU admission until the onset of AKI. Investigators investigated whether or not even little variations in creatinine levels might accurately predict the onset of acute kidney injury (AKI), both on their own and in conjunction with other risk factors associated with AKI. About 215 (57%) of 377 patients with 3,235 creatinine measurements and 15,075 creatinine change episodes developed AKI, while 68 (18%) acquired stage 2 or 3 AKI. In isolation, a creatinine increase over 4.1–7.3 h predicted stage 2 or 3 AKI within 3–37.7 h with an area under the curve of 0.65. The combination of creatinine increases of more than or equal to 1 μmol/L/h (≥0.0113 mg/dL/h) over 4–5.8 h with 3 AKI risk factors (cardiac surgery, use of vasopressors, chronic liver disease) had a sensitivity of 83%, a specificity of 79%, and an area under the curve of 0.87 for stage 2 or 3 AKI occurring 8.7–25.6 h later. In critically sick patients, frequent point-of-care creatinine evaluation on arterial blood gases to detect minor, short-term creatinine variations was a reliable, new, low-cost, and speedy technique for detecting acute kidney injury (AKI).
Source – sciencedirect.com/science/article/abs/pii/S0883944122001265
