Ferrari et al reported a simple score for predicting acute kidney injury in patients admitted to the intensive care unit (ICU). This can help to identify a patient who is at greater risk of developing acute kidney injury (AKI). The authors are from multiple institutions in Europe and Columbia.
Patient selection: admission to multidisciplinary intensive care unit (ICU)
Parameters:
(1) obesity
(2) eGFR in mL per min per 1.73 square meters
(3) cardiovascular component of the SOFA score (hypotension, from 0 to 4)
(4) serum lactate in mmol/L
(5) product of TIMP-2 and IGFBP7 (commercial test Nephrocheck, each in ng per mL, with product units ((ng/mL)^2)/1000)
Parameter
Finding
Points
obesity (BMI>30)
no
0
yes
1
eGFR
>= 90
0
< 90
3
cardiovascular score
0 or 1
0
>= 2
2
serum lactate
< 2 mmol/L
0
>= 2 mmol/L
2
TIMP-2 * IGFBP7
< 0.3
0
>= 0.3
2
where:
• TIMP-2 = tissue inhibitor of metalloproteinase-2
• IGFBP7 = insulin-like growth factor binding protein 7
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the risk of AKI.
Score
AKI
0 to 2
14-20%
3 or 4
20-21%
5 or 6
34-43%
7 or 8
56-57%
9 or 10
69-77%
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