Drug May Reduce Time in ICU For Patients With AKI

The injectable serine protease inhibitor ulinastatin improves outcomes in dialyzed patients with acute kidney injury (AKI) receiving care in the intensive care unit (ICU), according to a recent study.

Findings were presented by Dr Sonia Gupta on August 29, 2017, at the 2nd Annual Kidney Congress in Philadelphia, Pennsylvania.
_____________________________________________________________________________________________________________

RELATED CONTENT
Which Factors Contribute to Acute Kidney Injury After Primary PCI?
FDA Approved Test to Predict Acute Kidney Injury
_____________________________________________________________________________________________________________

Mortality rates have reached 50% to 80% among critically ill, dialyzed patients with AKI in the ICU, despite the availability of intensive renal support. Currently, no specific or targeted therapy for AKI exists. However, ulinastatin, a multifunctional Kunitz type serine protease inhibitor, has demonstrated significant renoprotective effects in various types of mechanical and chemical injury.

To assess the effects of ulinastatin on outcomes in patients with AKI, Gupta and colleagues evaluated 280 patients with AKI who needed ICU care between May 2012 and December 2015. Patients with AKI who had sequential organ failure assessment scores higher than 8 were included in the study. Half of the patients received 3 daily doses of injectable ulinastatin for 5 days and were compared with the other half of patients in a control group.

Over the course of the study, the researchers recorded patient ages and etiologies, length of stay, the need for and duration of renal replacement therapy, the need for mechanical ventilation, mortality and post-AKI recovery and progression to chronic kidney disease (CKD).

Results indicated that patients who had received ulinastatin had a shorter length of stay in the ICU, as well as a shorter time to stoppage of renal replacement therapy. A total of 118 (84%) patients had demonstrated recovery of renal function. The progression to CKD was observed in 10 patients who had received ulinastatin and 20 controls. Overall, patients had required a mean of 11 sittings of dialysis. However, patients receiving ulinastatin needed fewer sittings of dialysis.

Additionally, the researchers found that the overall mortality rate was 26%. Of the 72 patients who had died, 39 were in the control group.

“The patients who received ulinastatin had a shorter stay in the ICU,” the researchers concluded. “Also, the time to stoppage of renal replacement therapy was shorter.”

—Christina Vogt

Reference:

Gupta S. Ulinastatin: Is it a new therapeutic option for AKI? Paper presented at: 2nd Annual Kidney Congress; August 28-30, 2017. Philadelphia, PA. http://kidney.conferenceseries.com/abstract/2017/ulinastatin-is-it-a-new-therapeutic-option-for-aki.