Admission blood gas variables and electrolytes in predicting significant endpoints in ICU patients with emerging acute kidney injury.

Abstract

Introduction Acute kidney injury (AKI) is a prevalent issue in intensive care units (ICUs). There is a paucity of data regarding the use of blood gas and electrolyte measurements in predicting the risk of significant endpoints (kidney replacement therapy, death) in emerging, yet undiagnosed AKI. Methods Retrospective, observational, single-center study. The study documented 4 admission electrolytes (serum sodium, potassium, ionized calcium, and phosphate) and 3 admission blood gas variables (arterial pH, actual bicarbonate, pCO2). The endpoints of the study were the need for kidney replacement therapy (KRT) and death in the ICU. Results A total of 213 patients were included in the study. The ICU mortality rate was 31%, and 22.5% of all subjects required at least one individual KRT session. There were significant differences in admission serum sodium and phosphate levels between survivors and non-survivors (both lower in survivors), and in arterial pH and actual bicarbonate levels (both higher in survivors). The majority of all tested variables were identified as independent predictors of either the need for KRT or ICU death. Conclusions Integrating admission electrolytes and blood gas variables may potentially aid in identifying subsets of acute kidney injury (AKI) patients at risk of death.