Analysis of risk factors of acute kidney injury in organ donors

Background: To investigate the occurrence and risk factors of acute kidney injury (AKI) in organ donors. Methods: Clinical data of 153 donor patients who donated organs in our hospital from January 2016 to July 2018 were collected. Patients were divided into AKI group and non-AKI group according to AKI diagnostic criteria. Clinical indicators of patients in the two groups were compared, and the related risk factors were analyzed by unifactorial and multivariate logistic regression. Results: The incidence of donor patients complicated with AKI was 48.37%. Unifactorial analysis suggested that the SOFA score, positive rate of blood culture, hypothermia incidence and vasoactive drug dose in donor AKI group were larger than those in non-AKI group. Multivariate Logistic regression analysis showed that the dose of booster drugs (P=0.02, OR=3.53) and the positive rate of blood culture (P=0.01, OR=6.64) were independent risk factors for donor patients complicated with AKI. Conclusion: The incidence of acute kidney injury in organ donors is high, with the dose of booster drugs and the positive rate of blood culture as independent risk factors for evaluation basis to assess the incidence rate of donor patients complicated with AKI.

The Role of Procalcitonin in the Diagnosis and Prognosis of Severe Surgical Patients with Sepsis

Purpose:To investigate the clinical significance of serum procalcitonin (PCT) concentrations and related indicators of infection in the early diagnosis and prognosis of severe surgical patients with infection. Methods: This study included 77 critically ill patients taken from the Surgery Department to the Intensive Care unit between June 2015 and July 2017. Patients were divided into control, sepsis and septic shock groups, and their serum concentrations of PCT and related indicators of infection were compared. Results: PCT levels increased significantly from the control to the sepsis group and from the sepsis to the septic shock group (P<0.01 each). There were no significant differences in white blood cell (WBC) count, neutrophil percentage and body temperature among the groups (P>0.05). Receiver operating curve (ROC) analysis showed that the areas under the curve (AUC) for PCT, WBC count, neutrophil percentage and body temperature were 0.949, 0.657, 0.640 and 0.656, respectively. PCT, with 0.52 µg/L as the cut-off concentration, had the highest performance in the diagnosis of severe surgical sepsis, with a sensitivity of 96.1%, a specificity of 92.3% and a Youden index of 0.884. Conclusion: PCT concentration is diagnostic of infection in severe surgical patients, has high specificity in the early diagnosis of sepsis, and can reflect the severity of infection.