Elevated levels of Nt-proBNP, proinflamatory cytokines, procalcitonin and lactate are associated with increased risk of mortality in Sepsis and Acute Renal Injury pa-tients

HUESPE, LUIS; MELANA COLAVITA, JUAN PABLO; STOYANOFF, TANIA ROMINA; AGUIRRE, MARÍA VICTORIA; AUCHTER, MÓNICA; RODRÍGUEZ, JUAN PABLO

Rio de Janeiro

Congreso; International Sepsis Forum; 2019

Sepsis is a potentially fatal organ dysfunction caused by a dysregulated host response to infection. Acute kidney Injury is the most frequent complication in patients with septic shock and is an independent risk factor for death. Patients diagnosed with Sepsis-3 were included in a prospective observational protocol with the following objectives: 1) Mortality at 28 and 90 days, 2) Acute Renal Injury and causes of non-recovery at 7 days and 3) Type-5 Cardiorenal Syndrome. All patients with Sepsis-3 were were included in the study (December 2017-December 2018.) Epidemiological data, SOFA, Nt-proBNP, proinflamatory cytokines, procalcitonin, lactate, primary site of infection, microbiological culture, days of ventilación and standard care were determined. To identify the subgroup of patients with ARF, we used sepsis as an initial insult and the KDIGO criteria to determine creatinine increase ≥ 0.3 mg / dl or 50% of the previous lower value within 48 hours of admission to the protocol, or urine volume 1000 and mortality was 40%. If we compare it to this subgroup over the totality of the annual patients, mortality was 3.63%, renal replacement therapy 1.29%, septic shock 14.02% and sepsis-3 22.07%. The use of vasoactive drugs 10.03% and Cardiorenal Syndrome type-5 was 8.05%. All patients have elevated levels of interleukins 6,7,10 and 12 Acute Kidney Injury and non-recovery at seven days after the initial insult in patients with sepsis and septic shock increases the mortality at 90 days. The identification of a subgroup of patients is useful for directing therapeutics and biomarker determinations are necessary. The association of renal involvement and transient cardiac failure can make us suspect the presence of type 5 cardiorenal syndrome.