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Comparative evaluation of Acute Kidney Injury associated or not with sepsis in elders admitted in Intensive Care Units

Grant number: 14/17018-2
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): December 01, 2014
Effective date (End): November 30, 2015
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal researcher:André Luís Balbi
Grantee:Beatriz Motta Sampaio
Home Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Acute Kidney Injury (AKI) is a frequent pathology, mainly in critical patients, achieving 40% in Intensive Care Units (ICU). Many factors may lead to AKI development, especially advanced age that can be associated with structural and functional kidney tissue frailty and sepsis, syndrome very frequent and with high mortality rates (30-60%) in ICU. This study aims to evaluate the prevalence of different AKI etiologies in ICU patients from Hospital das Clínicas da Faculdade de Medicina de Botucatu-UNESP (HCFMB), compare the evolution of elders who developed AKI associated or not with sepsis, and identify the risk factors associated with death in these patients. It will be done in an observational prospective cohort of 60-year-old or more patients, followed by 12 consecutive months. Considering that AKI incidence in elder people admitted in ICU would be 40%, it could estimate a 200 patients sample in the end of this period. It will be excluded from this study patient aged under 60 years old, those with AKI diagnosis in ICU admission, Chronic Kidney Disease (CKD) patients, and kidney transplant recipients. Each selected patient will have a protocol filled by one observer only, with clinical and medical test information, from admission until outcome (death or discharge). The kidney's function will be daily evaluated by the measure of serum creatinine and by the measure of urinary debit and the AKI diagnosis will be analyzed by AKIN method. The results will be presented firstly by a descriptive analysis from every elder with AKI hospitalized in ICU who will be divided in to two groups (AKI associated with sepsis and AKI non-associated with sepsis) which will be compared between them about patients clinical characteristics and patients evolution. It also will be used the Chi-square test for comparing categorical variables and the Student t-test for continuous variables. Next, multivariate data analysis will be done, through a logistic regression model, from numbers obtained an Odds Ratio (OR), being included all independent variables that will show association with the outcome with pd0.20. Equal procedure will be developed from death, as a dependent variable. All results from hypotheses tests will be discussed at a level of 5% of significance (p<0.05).