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Table 6 Variables predictive of SSAKI in selected major adult trials

From: Identification of candidate serum biomarkers for severe septic shock-associated kidney injury via microarray

Study

Criteria

SSAKI (%)

Variable outcome

PROWESS [39]

Pre-infusion log IL-6, APACHE II score

127/547 (23.2)

Hazard ratio = 1.16 (95% CI = 1.07 to 1.26); P <0.001

   

Hazard ratio = 1.23 (95% CI = 1.09 to 1.39); P <0.001

NORASEPT II [54]

Plasma IL-6

112/537 (20)

Not significant

 

Plasma TNFα

 

Not significant

 

Soluble TNFα receptor type I

 

Higher in SSAKI; P <0.0001

 

Soluble TNFα receptor type II

 

Higher in SSAKI; P <0.0001

PICARD [40]

Plasma TNFα

34/97 (35)

Higher in patients with SSAKI (P = 0.001) than those without sepsis

 

Plasma IL-6

 

Not significant

Hoste and colleagues [55]

APACHE II score

30/185 (16.2)

APACHE II score higher (P = 0.002)

 

pH <7.35

 

OR for developing ARF = 6.25 (95% CI = 1.92 to 20.4); P = 0.002

 

Serum creatinine >1 mg/dl

 

OR for developing ARF = 7.56 (95% CI = 2.16 to 26.5); P = 0.002

Martensson and colleagues [56]

Peak serum NGAL

18/45 (40)

Not significant in SSAKI vs. septic shock without AKI

 

Peak urine NGAL

 

Higher in SSAKI than septic shock without AKI (P <0.05)

Shapiro and colleagues [43]

Emergency room plasma NGAL

24/661 (3.6)

NGAL >150: sensitivity = 96% and specificity = 51%

de Geus and colleagues [42]

Serum NGAL

171/632 (27)

OR of developing ARF = 1.7

 

Urine NGAL

 

OR of developing ARF = 1.42

 

Sepsis

 

OR of developing ARF = 9.15

  1. AKI, acute kidney injury; APACHE, Acute Physiology and Chronic Health Evaluation; CI, confidence interval; NGAL, neutrophil gelatinase-associated lipocalin; NORASEPT, North American Study for the Safety and Efficacy of Murine Monoclonal Antibody to Tumor Necrosis Factor Alpha for the Treatment of Septic Shock; OR, odds ratio; PICARD, Program to Improve Care in Acute Renal Disease; PROWESS, Prospective Recombinant Activated Protein C Worldwide Evaluation in Severe Sepsis; SSAKI, sepsis-shock-associated acute kidney injury; TNF, tumor necrosis factor.