Elevated strong ion gap: A predictor of the initiation of continuous renal replacement therapy in acute kidney injury


GÜÇYETMEZ B., SARIKAYA Z. T., Tuzuner F.

AMERICAN JOURNAL OF THE MEDICAL SCIENCES, cilt.367, sa.2, ss.112-118, 2024 (SCI-Expanded) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 367 Sayı: 2
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1016/j.amjms.2023.11.012
  • Dergi Adı: AMERICAN JOURNAL OF THE MEDICAL SCIENCES
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, Veterinary Science Database
  • Sayfa Sayıları: ss.112-118
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Background: There is no optimal timing for continuous renal replacement therapy (CRRT) in acute kidney injury (AKI). AKI is a reason for the increased unmeasured anions, which refers to the increased organic acids in the blood, and they can be detected by calculating strong ion gap (SIG). SIG level at the moment of the AKI diagnosis may be a predictor for the initiation of CRRT. Methods: Patients who were diagnosed with AKI in the first week of the intensive care unit (ICU) period were included in this prospective observational study. At the moment of the AKI diagnosis, blood gas samples were recorded, and SIG was calculated. Results: The median level of SIG at the moment of the AKI diagnosis of CRRT (+) patients was significantly higher than CRRT (-) patients (7.4 and 3.2 mmol L -1, respectively). In the multivariate Cox regression analysis, the likelihood of the initiation of CRRT was increased 1.16 -fold (1.01-1.33) and 4.0 -fold (1.9-8.7) by only 1 mmol L(-1 )increases in SIG and SIG >= 6 mmol L-1( ) at the moment of AKI diagnosis, respectively (p = 0.035 and p < 0.001). Conclusions: Increased SIG at the moment of the AKI diagnosis in patients with AKI may be a predictive marker to initiate CRRT.