肾脏病学与治疗学杂志

When it comes to fitness routines, Chronic Kidney Disease (CKD) sufferers are sometimes disregarded. Although, in the medical world, a majority of nephrologists believe that their patients should exercise regularly to improve their general health. Physical inactivity contributes to a decrease in everyday activities and a lower quality of life. People with CKD can improve their balance and coordination by strengthening their muscles, bones, and joints through exercise. This can help individuals avoid falling and maintain their independence as they get older. Furthermore, it is well recognised that CKD patients are at a greater risk of dying prematurely from cardiovascular disease, owing in part to their sedentary lifestyle.

Introduction: Acute kidney injury is a frequently encountered outcome in critically ill patients, accounting for increased mortality. A large proportion of these patients require hemodialysis. This study is an attempt to assess the use of neutrophil gelatinase associated lipocalin to timely predict the requirement of hemodialysis so that such patients can be managed aggressively.

Methods: A prospective observational study was conducted at various tertiary care Hospital from August 1st 2020 to March 15th 2021, which included only critically ill patients with sequential organ failure assessment score >1 and requiring intensive care unit admission. Patients of known renal diseases were excluded from the study. Blood as well as urinary samples for neutrophil gelatinase associated lipocalin and other laboratory parameters were collected within 8 hours of admission. Patients who developed renal dysfunction were noted as our cases and the others were noted as controls.

Results: The study was done on 375 patients, out of which 201 developed acute kidney injury while 174 did not develop acute kidney injury. The Area under curve for serum and urinary neutrophil gelatinase associated lipocalin was 0.902 (95% CI- 0.846-0.964) and 0.933 (95% CI- 0.884- 0.983) respectively (p value <0.001).

Conclusion: Neutrophil gelatinase associated lipocalin has distinguished itself to be a marker of acute kidney injury and our study reinforces the same, while also demonstrating its role in early prediction of hemodialysis so that various metabolic derangements can be corrected at the earliest, thus, decreasing mortality.