ESPN 51th Annual Meeting

ESPN 2018


 
Utilization of Renal Angina Index in PICU of a developing country for prediction of subsequent severe acute kidney injury
GURDEEP SINGH DHOORIA 1 RAINA KAUR 1 PUNEET AULAKH POONI 1 DEEPAK BHAT 1 SIDHARTH BHARGAVA 1 SHRUTI KAKKAR 1 KAMAL ARORA 1

1- DAYANAND MEDICAL COLLEGE AND HOSPITAL, LUDHIANA, PUJAB, INDIA
 
Introduction:

 Acute kidney injury (AKI) is independently associated with worsened morbidity and increased mortality in PICU. AKI risk stratification, termed renal angina index (RAI) has been used in the west  to predict persistent severe AKI. Very few studies have been done on application of RAI in PICU in developing countries. Aim: To predict severe subsequent AKI in PICU using Renal Angina Index.

Material and methods:

  Design: Prospective observational study.  Methods: Children admitted over one year in PICU between one month to 18 years of age with no previous kidney disease were included. RAI assessment was done from 8-12 hours of admission to PICU. RAI was calculated from product of Renal Risk  and Renal Injury score. Renal angina positivity was defined as RAI  ≥ 8. On day 4, serum creatinine is noted and eGFR is calculated. RAI was correlated with presence/absence of subsequent severe AKI. RAI positivity was also correlated with duration of PICU stay, need for dialysis, mechanical ventilation and mortality.

Results:

 RAI positivity was seen in 16.7 % cases. In the  RAI positive cases, 36.2 %  developed AKI at 4 days compared to 2.3% in RAI negative cases (p value <0.001). Mean duration of PICU stay in RAI positive group was 7.19 ± 5.13 days vs 4.72 ± 2.71 days in RAI negative group. Nearly 31% cases in RAI positive cases had poor outcome.

Conclusions:

 

Renal angina index could be used as a simple and important bedside tool to predict patients at risk of severe AKI.