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Description

Bhatraju et al reported a model for predicting severe acute kidney injury (AKI) in a patient in the intensive care unit (ICU). This can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Washington in Seattle, Harvard University and Massachusetts General Hospital.


ACT is an acronym for age, cirrhosis, and sTNFR-1

 

Patient selection: adult in ICU, excluding trauma, intracranial hemorrhage, HIV, immunosuppression, cancer, ESRD or kidney transplant

 

Parameters:

(1) age in years

(2) cirrhosis

(3) serum sTNFR-1 (soluble TNF receptor-1)in pg/mL

 

Parameter

Finding

Points

age in years

 

-0.04 * (age)

cirrhosis

no

0

 

yes

-2.59

TNFR

 

8.51 * LOG10(TNFR1)

 

value of X =

= SUM(points for all of the parameters) - 35.7

 

probability of severe AKI =

= 1 / (1 + EXP((-1) * X))

 

Performance:

• The area under the ROC curve was 0.90 in the derivation and 0.93 in the validation cohorts.


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