title: Troponin I serum levels predict the need of dialysis in incident sepsis patients with acute kidney injury in the intensive care unit.
abstract: BACKGROUND
  Sepsis, an extremely prevalent condition in the intensive care unit, is usually associated with organ dysfunction, which can affect heart and kidney.
  
  
  OBJECTIVE
  To determine whether the cardiac dysfunction and the Troponin I forecast the occurrence of acute renal failure in sepsis.
  
  
  METHODS
  Cardiac dysfunction was assessed by echocardiography and by the serum troponin I levels, and renal impairment by AKIN criteria and the need of dialysis. Twenty-nine patients with incident sepsis without previous cardiac or renal dysfunction were enrolled.
  
  
  CONCLUSIONS
  Patients averaged 75.3 ± 17.3 years old and 55% were male. Median APACHE II severity score at ICU admission was 16 (9.7 - 24.2) and mortality rate in 30 days was 45%. On the fifth day, 59% had ventricular dysfunction. Troponin serum levels on day 1 in the affected patients were 1.02 ± 0.6 ng/mL compared with 0.23 ± 0.18 ng/mL in patients without heart dysfunction (p = 0.01). Eighteen out of 29 patients (62%) underwent renal replacement therapy (RRT) and the percent of patients with ventricular dysfunction who required dialysis was higher (94% vs. 16%, p = 0.0001). Values of troponin at day 1 were used to develop a ROC curve to determine their ability to predict the need of dialysis. The area under the curve was 0.89 and the cutoff value was 0.4 ng/mL.
  
  
  CONCLUSIONS
  We found that an elevation in serum troponin levels, while guarding a relationship with ventricular dysfunction, can be a precious tool to predict the need for dialysis in sepsis patients.
authors.affiliation: Hospital Icaraí, Brazil.
authors.forename: Daniel da Almeida
authors.initials: Dda A
authors.lastname: Thiengo
authors.affiliation: Universidade Federal Fluminense, Brazil.
authors.forename: Jocemir Ronaldo
authors.initials: JR
authors.lastname: Lugon
authors.affiliation: Universidade Federal Fluminense, Brazil.
authors.forename: Miguel Luis
authors.initials: ML
authors.lastname: Graciano
mesh_terms: D018806:APACHE; D058186:Acute Kidney Injury / Q000097:blood* / Q000150:complications / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D018805:Sepsis / Q000097:blood / Q000150:complications*; D019210:Troponin I / Q000097:blood*; D018754:Ventricular Dysfunction / Q000150:complications
chemical_list: D019210:Troponin I