ABSTRACTS CRITICARE – IJCCM2021 1. Acute Kidney Injury and Hemofiltration being 51.97 ± 10.52. Nephrotic level proteinuria (4+) is significantly high (22.2%) in Group1 patients as compared to the rest. Group 3 predominantly (34.3%) shows insignificant proteinuria which is less 1. Acute Kidney Injury in Severely Preeclamptic Patients Admitted than 250 mg/day. 3+ proteinuria is most common. Discussions: to ICU: Epidemiology and Role of Serum Neutrophil Gelatinase- NDKD amounted to 52.87% [out of which NDKD superimposed on Associated Lipocalcin. (Conference Abstract ID: 176) diabetic kidney disease (DKD) was 30%, isolated NDKD was 22.87%]. Pooja Yadav, Asha Tyagi, Asha Tyagi, Rashmi Salhotra, Shukla The pro-portion of NDKDs ranged from 21 to 52% in other studies. Das, Praveen Singh Conclusion: NDKDs do occupy a considerable fraction of kidney UCMS and GTB Hospital, Delhi, India diseases of type 2 diabetes patients. Their presentation is however DOI: 10.5005/jp-journals-10071-23711.1 different (low degrees of proteinuria, younger patient age). Introduction: Critically ill preeclamptic patients may have risk factors for acute kidney injury (AKI). Neutrophil gelatinase- 3. Failing Kidney and a Preserved Heart. (Conference Abstract associated lipocalcin (NGAL) is a validated biomarker to predict ID: 92) AKI. We could locate scanty data regarding the epidemiology of C Jayadevi AKI and the role of NGAL in preeclamptic patients admitted to Govt Villupuram Medical College Hospital, Villupuram, Tamil Nadu, ICU. Materials and methods: Preeclamptic patients admitted to India multidisciplinary ICU were included. The occurrence of AKI and its DOI: 10.5005/jp-journals-10071-23711.3 severity for the entire ICU stay using KDIGO criteria, risk factors, and serum NGAL were assessed. Results: From 52 preeclamptic patients Introduction: About a half of patients with heart failure have heart admitted to ICU, majority had eclampsia (75%). The ICU mortality failure with preserved ejection fraction (HFpEF), nevertheless HFpEF was 15.4%. AKI developed in 25 (48.1%) patients; with stage 1, 2 could be overlooked in the intensive care unit (ICU). The symptoms and 3 in 56%, 36% and 8% respectively. Incidence of sepsis (16% of HFpEF are similar to those of heart failure with reduced ejection versus 0%), shock (40% versus 7.4%), and anaemia (84% versus fraction (HFrEF). Acute decompensated HFrEF is a well-known cause 59.3%) was significantly greater in patients with AKI (P < 0.05). ICU of oliguric acute kidney injury (AKI) and it may present as severe AKI mortality (28% versus 3.7%), duration of ICU and hospital stay were requiring extracorporeal ultrafiltration therapy. AKI resulting from significantly higher in preeclamptics with AKI (P < 0.05). Serum acute decompensated heart failure constitutes acute cardiorenal NGAL (274 [240-335] ng/ml) showed no association with AKI or syndrome (CRS) also referred to as type 1 CRS. HFpEF could also mortality (P = 0.725, 0.861); but significant prediction for eclampsia lead to AKI but the diagnosis of HFpEF may be overlooked in the [P = 0.019; AUC = 0.736 (95% CI: 0.569 – 0.904)]. Discussions: The setting of AKI since the congestive manifestations of HFpEF are present prospective cohort study aimed to evaluate AKI in a specific akin to volume overload symptoms resulting from AKI. In such a subset of critically ill obstetric patients viz., those with preeclampsia. setting unless thoughtfully considered, the diagnosis of HFpEF While there is little previous data on AKI in critically ill preeclamptic might be overlooked and the etiology of AKI may remain elusive. patients, it has been evaluated among those with the disease but It is crucial to make a prompt diagnosis of HFpEF in the ICU to fix not admitted to ICU.11–13 The incidences herein were reported in a the etiology of AKI in the ICU. We report the case of a 70-year-old lower percentage than our results viz., 15.3 and 17%.11,12 The much woman who presented with oliguric AKI, marked edema, NYHA greater incidence noted by us can be attributed to an increased class IV heart failure, and summarize the diagnostic workup that presence of risk factors for AKI encountered in those admitted to the led to a final diagnosis of HFpEF. Materials and methods: A 70-year- ICU, such as, sepsis and shock. Conclusion: AKI is common among old woman presented to the emergency room with dyspnea at preeclamptic patients admitted to ICU, but serum NGAL does not rest, orthopnea, ankle edema of 1-week duration, and oliguria of predict AKI in these patients. 1-day duration. Her urine output was 300 mL in 24 hours. She was a known diabetic and hypertensive. During a routine evaluation 3 months before the current illness, her urine dipstick revealed no 2. Clinicopathological Spectrum of Kidney Diseases in Patients overt proteinuria and her serum creatinine was 0.7 mg/dL with an with Type 2 Diabetes Mellitus: A Record-based Retrospective eGFR of 88 mL/min/1.73 m2 by CKD-EPI equation. On admission, she Study. (Conference Abstract ID: 128) was dyspneic, tachypneic, extremities were warm, she had bilateral Vijay Patidar, RK Jha, Sonam Verma pitting ankle edema, jugular venous pressure (JVP) was raised, Sri Aurobindo Medical College and Postgraduate Institute, Indore, pulse was 102/minute, regular, BP was 160/90 mm Hg, oxygen Madhya Pradesh, India saturation while breathing ambient air was 82%, auscultation DOI: 10.5005/jp-journals-10071-23711.2 revealed normal heart sounds and bilateral basal rhales. She had Introduction: Non-diabetic kidney diseases (NDKD) have been a body mass index (BMI) of 26 kg/m2. Electrocardiogram revealed observed to contribute to a considerably large fraction (one- sinus tachycardia, left ventricular hypertrophy. Chest X-ray revealed third)1–4 of kidney diseases among patients with type 2 diabetes cardiomegaly, bilateral pleural effusion, and pulmonary venous mellitus. Through this study, an estimate of the general pattern of congestion. Echocardiogram revealed concentric left ventricular diabetic, non-diabetic, and mixed kidney disease will be obtained. hypertrophy, left ventricular ejection fraction (LVEF) of 52%, the Materials and methods: Study design: Record-based retrospective systolic pressure in the pulmonary artery by Doppler was 37 mm study. Study place: SAIMS Medical College Indore. Inclusion: All Hg indicating pulmonary hypertension, E/e’ by tissue Doppler type 2 diabetic patients with kidney disease who have undergone imaging was 19.1 indicating increased filling pressure, there biopsy. Results: A total of 153 patients underwent biopsy. Out of was no regional wall motion abnormality. The inferior vena cava which 110 were men and 43 were women, and the average age measured 22 mm. Her central venous pressure was 19 mm Hg. Indian Journal of Critical Care Medicine: ABSTRACTS CRITICARE – IJCCM2021 S1 ABSTRACTS CRITICARE – IJCCM2021 Urine analysis revealed trace protein, spot urine sodium was 4 Academy of Higher Education (MAHE), Manipal, Karnataka, India mol/L. Ultrasonogram revealed normal-sized kidneys with normal DOI: 10.5005/jp-journals-10071-23711.4 cortical echoes. Her serum creatinine was 1.2 mg/dL (eGFR 48 mL/ 2 Introduction: Acute kidney injury and sepsis are highly prevalent min/1.73 m ) NT-Pro BNP was 17,100 pg/mL (reference < 300 pg/ in intensive care patients (20–50%) and have a direct effect on mL) and BNP was 241 pg/mL (reference < 100 pg/mL). Results: This mortality and morbidity. Our objective was to evaluate if acute patient presented with stage 3 AKI (1) with oliguria lasting for 24 kidney injury (AKI) is going to be persistent or transient in patients hours. Her serum creatinine had increased from 0.7 to 1.2 mg/dL. admitted with sepsis to intensive care unit (ICU), using variables A low spot urine sodium and a high blood urea/creatinine ratio are collected at the time of admission and to develop a formula— suggestive of a renal hypoperfusion state. She had manifestations persistent AKI scoring system (PASS) to predict recovery. Materials like resting dyspnea, edema, raised JVP, resting hypoxia and and methods: The study was conducted over a period of 8 months pleural effusion consistent with decompensated heart failure. with a total sample size of 63 participants who were critically ill ICU Given the presentation with marked peripheral and pulmonary patients diagnosed with sepsis and AKI. The study was conducted congestion that was disproportionate to the fall in GFR one would after approval from the ethics and scientific committee and be inclined to consider differentials like acute glomerulonephritis informed consent forms were obtained from the patients/relatives and acute or type 1 cardiorenal syndrome (CRS). Discussions: before inclusion. Parameters like serum creatinine (SCr), base excess Type 1 CRS becomes the prime diagnostic consideration in this 3 (BE), plethysmographic variability index (PVI), caval index, R wave patient. The LVEF by definition is <40% in HFrEF. This patient variability, mean arterial pressure (MAP), and renal resistivity index had an ejection fraction of 52% and her clinical presentation with (RI) using renal Doppler and need for vasopressors were assessed heart failure should arouse suspicion of HFpEF. Although HFpEF on admission. Patients were managed with standard protocols with accounts for about a half of the patients with heart failure,4 it is 4,5 fluid resuscitation and other specific treatments. After 6 hours of often overlooked in clinical practice. Diagnosis of HFpEF relies fluid resuscitation, the hemodynamic status and volume status on excluding other cardiac and non-cardiac causes of dyspnea in a of the patient was assessed. Patients were classified as volume patient presenting with symptoms and signs consistent with heart responders or non-responders depending on hemodynamic failure and preserved left ventricular ejection fraction > 50%. The 6 stabilization using parameters like systolic blood pressure and H2FPEF scoring system is a clinical tool that utilizes clinical and MAP.