Diagnosing acute kidney injury ahead of time in critically ill septic patients using kinetic estimated glomerular filtration rate
Authors' conclusion
Predictive performance of KeGFR combined with UO criteria for diagnosing AKI is excellent. Compared to KDIGO, deterioration of renal function was identified earlier, most prominently for lower stages of AKI.
Study context
- Population
- Septic ICU patients in AmsterdamUMCdb
- Participants
- 2,492 patients
- Exposure
- Kinetic estimated Glomerular Filtration Rate (KeGFR) with urine output (UO) criteria vs KDIGO for Acute Kidney Injury (AKI) diagnosis
- KeGFRn = 1,706
- KDIGOn = 1,560reference
- Outcome
- Predictive performance of KeGFR for AKI and time between prediction and diagnosis
Methodological detailsdiagnostic accuracy, database study (AmsterdamUMCdb)
- Diagnostic accuracy
- Database study (AmsterdamUMCdb)
Main finding
As reported in the abstract
AKI diagnosis
| Group | Value | Sensitivity | Specificity | Accuracy | Kappa (disease stages) |
|---|---|---|---|---|---|
| KeGFR | 68.5% | 93.2% | 73.0% | 85.7% | 0.77 |
| KDIGO | 62.0% |
Value
KeGFR68.5%
KDIGO62.0%
Sensitivity
KeGFR93.2%
KDIGO— not stated in the abstract
Specificity
KeGFR73.0%
KDIGO— not stated in the abstract
Accuracy
KeGFR85.7%
KDIGO— not stated in the abstract
Kappa (disease stages)
KeGFR0.77
KDIGO— not stated in the abstract
h
- Median time to recognition of AKI Stage 1 faster for KeGFR
- 13.2
- Median time to recognition of AKI Stage 2 faster for KeGFR
- 7.5
- Median time to recognition of AKI Stage 3 faster for KeGFR
- 5.0
Observational data: associations, not effects.
Further findings
ICU LOS and 28-day mortality
- Slight difference in LOS and 28-day mortality for Stage 1
Original publication
Diagnosing acute kidney injury ahead of time in critically ill septic patients using kinetic estimated glomerular filtration rate. J Crit Care. Published 10 February 2023. doi:10.
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