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Observational Study
. 2018 Nov 20;19(1):329.
doi: 10.1186/s12882-018-1129-5.

Troponin I at admission in the intensive care unit predicts the need of dialysis in septic patients

Daniel de Almeida Thiengo  1 , Jorge P Strogoff-de-Matos  2 , Jocemir Ronaldo Lugon  2 , Miguel Luis Graciano  3   4
Affiliations
Observational Study

Troponin I at admission in the intensive care unit predicts the need of dialysis in septic patients

Daniel de Almeida Thiengo et al. BMC Nephrol. .

Abstract

Background: In a previous study we showed that troponin I (TnI) > 0.42 ng/mL predicted the need of dialysis in a group of 29 septic patients admitted to the intensive care unit (ICU). We aimed to confirm such finding in a larger independent sample.

Methods: All septic patients admitted to an ICU from March 2016 to February 2017 were included if age between 18 and 90 years, onset of sepsis < 24 h, normal left ventricular ejection fraction, and no previous coronary or kidney diseases. TnI was measured on day 1. Patients were followed by 30 days or until death.

Results: A total of 120 patients were included (51% male, 74 ± 13 years old). At ICU admission, 70 patients had TnI > 0.42 ng/mL. These patients had serum creatinine slightly higher (1.66 ± 0.34 vs. 1.32 ± 0.39 mg/dL; P < 0.0001) than those with lower TnI and similar urine output (1490 ± 682 vs. 1406 ± 631 mL; P = 0.44). At the end of the follow-up period, 70.0% of the patients with lower TnI were alive in comparison with 38.6% of those with higher TnI (p = 0.0014). After 30 days, 69.3 and 2.9% of the patients with lower and higher TnI levels remained free of dialysis, respectively (p < 0.0001). In a Cox regression model, after adjustment for gender, age, Charlson comorbidity index, serum creatinine, potassium, pH, brain natriuretic peptide and urine output, TnI > 0.42 ng/mL persisted as a strong predictor of dialysis need (hazard ratio 3.48 [95%CI 1.69-7.18]).

Conclusions: TnI levels at ICU admission are a strong independent predictor of dialysis need in sepsis.

Keywords: Acute kidney injury; Biomarker; Sepsis; Troponin.

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Conflict of interest statement

Ethics approval and consent to participate

Project approved by the research ethics committee of the Faculdade de Medicina / Hospital Universitário Antonio Pedro.

Approved Project Number: CAAE 04180258000–11.

All participants provided written informed consent to participate in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
ROC curve of troponin I (a) APACHE II (b) SOFA (c) and serum creatinine (d) at ICU for predicting dialysis need
Fig. 2
Fig. 2
Kaplan-Meier curve for dialysis free survival, according to Troponin I levels at ICU admission
Fig. 3
Fig. 3
Kaplan-Meier survival analysis, according to Troponin I levels at ICU admission
See this image and copyright information in PMC

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