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- Title
Troponin I at admission in the intensive care unit predicts the need of dialysis in septic patients.
- Authors
de Almeida Thiengo, Daniel; Strogoff-de-Matos, Jorge P.; Lugon, Jocemir Ronaldo; Graciano, Miguel Luis
- Abstract
<bold>Background: </bold>In a previous study we showed that troponin I (TnI) > 0.42 ng/mL predicted the need of dialysis in a group of 29 septic patients admitted to the intensive care unit (ICU). We aimed to confirm such finding in a larger independent sample.<bold>Methods: </bold>All septic patients admitted to an ICU from March 2016 to February 2017 were included if age between 18 and 90 years, onset of sepsis < 24 h, normal left ventricular ejection fraction, and no previous coronary or kidney diseases. TnI was measured on day 1. Patients were followed by 30 days or until death.<bold>Results: </bold>A total of 120 patients were included (51% male, 74 ± 13 years old). At ICU admission, 70 patients had TnI > 0.42 ng/mL. These patients had serum creatinine slightly higher (1.66 ± 0.34 vs. 1.32 ± 0.39 mg/dL; P < 0.0001) than those with lower TnI and similar urine output (1490 ± 682 vs. 1406 ± 631 mL; P = 0.44). At the end of the follow-up period, 70.0% of the patients with lower TnI were alive in comparison with 38.6% of those with higher TnI (p = 0.0014). After 30 days, 69.3 and 2.9% of the patients with lower and higher TnI levels remained free of dialysis, respectively (p < 0.0001). In a Cox regression model, after adjustment for gender, age, Charlson comorbidity index, serum creatinine, potassium, pH, brain natriuretic peptide and urine output, TnI > 0.42 ng/mL persisted as a strong predictor of dialysis need (hazard ratio 3.48 [95%CI 1.69-7.18]).<bold>Conclusions: </bold>TnI levels at ICU admission are a strong independent predictor of dialysis need in sepsis.
- Subjects
TROPONIN I; INTENSIVE care units; HEMODIALYSIS; KIDNEY diseases; REGRESSION analysis
- Publication
BMC Nephrology, 2018, Vol 19, Issue 1, pN.PAG
- ISSN
1471-2369
- Publication type
journal article
- DOI
10.1186/s12882-018-1129-5