NATIONAL HARBOR, Md.—New-onset dipstick proteinuria may be a useful biomarker for predicting development of acute kidney injury (AKI) in critically ill septic patients, researchers reported at the National Kidney Foundation 2012 Spring Clinical Meetings.
AKI develops in nearly 30% of patients with severe sepsis, and microalbuminuria has been described in up to 87% of septic patients, the investigators noted.
Resident physician Javier Neyra, MD, and collaborators at Henry Ford Hospital in Detroit enrolled 470 patients hospitalized with severe sepsis. Of these, 328 underwent dipstick testing at admission. Serum creatinine increased by at least 0.3 mg/dL in 210 subjects (64%) within the first 72 hours of admission.
In this group, the researchers observed new-onset dipstick proteinuria in 114 patients (54%), which translated into a 75% positive predictive value for AKI, and in 91 of 166 subjects (55%) with AKI by Acute Kidney Injury Network (AKIN) criteria, for a PPV of 60%. New-onset dipstick proteinuria at the time of admission was independently associated with a 2.3 times increased likelihood of AKI, after adjusting for age, race, gender, comorbidities, and other factors.
The investigators concluded that new-onset dipstick proteinuria represents a simple, inexpensive biomarker in sepsis with predictive power for AKI.