Relationship of lactate and lactate clearance with 28-day mortality in patients with acute renal injury in the emergency department Lactate clearance in acute renal injury

Aim : Acute kidney injury is frequently diagnosed in emergency departments; AKI should be included in the preliminary diagnosis in a wide range of symptoms, from loss of appetite, nausea, vomiting, which can be considered as a mild illness, to uremic encephalopathy, which can be a reason for loss of consciousness at hospital admission. The aim of our study is to show whether lactate and lactate clearance have an effect on 28-day mortality in these patients. Material and Methods: In our study, the data of 600 patients who applied to the emergency department between 10.10.2019 and 10.06.2020 and were decided on dialysis treatment were examined prospectively. One hundred fifteen patients who met the inclusion criteria were included in the study. Age, gender, chronic diseases, laboratory findings, 28-day mortality status of the patients were recorded. Results: In our study, in which 115 patients were evaluated, 51 patients (44.34%) deceased. In our study, when ROC analysis of lactate values was performed in patients who had a mortality in 28 days, it was predicted that 80.4% would have no mortality in 28 days for lactate values below 1,215 lactate levels; there may be a mortality rate of 40.6% at levels >= 1,215. Discussion: AKI is an important cause of mortality and morbidity for patients admitted to the emergency department. It has been shown in our study that lactate is especially effective in mortality. It was found that the lactate clearance value of the deceased patients (-54,77 +/- 156,66) was lower than the lactate clearance of the survivors. The lactate 2 value was measured after dialysis in deceased patients, therefore, tissue perfusion and damage weres higher, but there was no statistically significant difference in lactate clearance values between survivors and deceased patients.