Acute kidney injury in patients with pneumonia with A/H1N1 influenza

Abstract

Background. A critical condition of any genesis may be accompanied by the development of multiple organ failure, one of the manifestations of which is acute renal injury. Often, the process is subclinical in nature and the «classical» approaches to diagnose renal damage by creatinine concentration, urea level and assessment of glomerular filtration rate may not fully reflect the degree of impaired renal function, while acute kidney injury is a well-known predictor of high hospital mortality among critically ill patients.Aims. The purpose of this study was to assess functional state of the kidneysby determining the serum concentration of the markers of kidney injury NGAL and Cystatin C in patients with pneumonia associated with influenza A/H1N1.Materials and methods. 85 patients with pneumonia associated with influenza A/H1N1 were examined, 30 patients with severe pneumonia, 55 with non-severe pneumonia. The control group was formed by 15 healthy donors. The serum concentration of NGAL and Cystatin C molecules was determined by flow cytometry on a Beckman Coulter analyzer (USA), using a Human Immune Checkpoint Panel 1 multiplex assay kit (Biolegend, USA). The glomerular filtration rate was calculated using the CKD-EPI formula.Results. It was found that in patients with severe pneumonia with the influenza A/H1N1, the concentration of NGAL increased 3.8 times compared with the control group, the concentration of Cystatin C increased 1.4 times, the glomerular filtration rate did not change.Conclusion. Timely diagnosis of subclinical kidney injury makes it possible to objectify the severity of the condition, make adjustments to therapy, which can help to an increase in the survival rate of critically ill patients.

Keywords

• influenza a/h1n1
• aki
• multiple organ failure
• ngal
• cystatin c