Mild to moderate proteinuria is a heralding sign for acute kidney injury and mortality for intensive care unit patients

Authors: HACI HASAN YETER, TOLGA YILDIRIM, NESRİN DAMLA EYÜPOĞLU, TURAL PASAYEV, ABDULLAH TARIK ASLAN, SILA ÇETİK, ÖMER FARUK AKÇAY, ARZU TOPELİ İSKİT, MUSTAFA ARICI

Abstract: Background/aim: Lack of early predictors of acute kidney injury is currently delaying timely diagnosis.This study was done to evaluate the relationship between mild to moderate proteinuria and incidence of acute kidney injury (AKI) and 28-day mortality in intensive care unit (ICU) patients. Material and methods: This observational, retrospective study was conducted in the internal medicine ICU. A total of 796 patients were screened and 525 patients were used for this analysis. Proteinuria was measured by urine dipstick test. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Results: Patients with dipstick urine protein positivity on admission had higher proportion of AKI and 28-day mortality compared to dipstick urine protein negative group [164 (59.6%) vs. 111 (44.4%) and 101 (36.7%) vs. 54 (21.6%), P = 0.01 and P < 0.01, respectively]. Urine dipstick protein positivity was also a significant predictor of 28-day mortality in patients with GFR > 60 mL/min (hazard ratio: 1.988, 95% confidence interval 1.380-2.862). Conclusion: Proteinuria before ICU admission is a risk factor for development of AKI within seven days of ICU stay and also is a risk factor for 28-day mortality, even in patients with GFR > 60 mL/min.

Keywords: Acute kidney injury, urine dipstick protein, proteinuria, 28-day mortality

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