Dados do Trabalho

Título

Pre-ECMO creatinine and GFR as predictors of acute kidey injury: unveiling key risk factors for post-ECMO outcomes

Objetivo

To investigate the relationship between pre-ECMO creatinine levels and glomerular filtration rate (GFR) with the development of acute kidney injury (AKI) post-ECMO.

Métodos

This observational, retrospective, unicenter study was performed at InCor- HCFMUSP from 2013 to 2021 to 2021.
A total of 160 patients were analyzed. Logistic regression assessed the association between pre-ECMO creatinine and GFR with AKI development. The 95% confidence intervals (CIs) were calculated for creatinine and GFR, and the study’s power was determined.

Resultados

We evaluated 160 patients on ECMO (40 VV and 120 VA), critically ill patients on inotropic and vasopressors drugs (dobutamine 126, norepinephrine 149, vasopressine 100, epinephrine 66). Pre-ECMO creatinine had a positive coefficient of 1.7039, indicating that higher levels were associated with a greater likelihood of developing AKI (p = 0.002). The study’s power was 1.0, indicating sufficient statistical power. The 95% CI for creatinine was 0.80–1.05 mg/dL in patients without AKI and 1.27–2.01 mg/dL in those with AKI. For GFR, patients with AKI had a median of 64.95 mL/min/1.73m² (95% CI: 60.84–86.85), while those without AKI had a median of 94.9 mL/min/1.73m² (95% CI: 84.54–106.31). Logistic regression showed a significant negative coefficient of -0.0162 for GFR, suggesting that lower GFR increased the probability of developing AKI (p = 0.018).

Conclusão

Higher pre-ECMO creatinine and lower GFR are significantly associated with increased AKI risk post-ECMO. Monitoring these parameters before ECMO can help identify patients at greater risk of AKI. The study had adequate power to detect these associations.