<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092024000600439</article-id>
<article-id pub-id-type="doi">10.35366/119230</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Asociación entre los niveles séricos de interleucina 6 para el desarrollo de lesión renal aguda al ingreso a la Unidad de Cuidados Intensivos en pacientes con síndrome de dificultad respiratoria grave]]></article-title>
<article-title xml:lang="en"><![CDATA[Association between serum levels of interleukin 6 and the development of acute kidney injury upon admission to the Intensive Care Unit in patients with severe respiratory distress syndrome]]></article-title>
<article-title xml:lang="pt"><![CDATA[Associação entre os níveis séricos de interleucina 6 e o desenvolvimento de lesão renal aguda na admissão à Unidade de Terapia Intensiva em pacientes com síndrome do desconforto respiratório grave]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Albuerne Estrada]]></surname>
<given-names><![CDATA[Isabella Joseline]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguirre Sánchez]]></surname>
<given-names><![CDATA[Janet Silvia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez Díaz]]></surname>
<given-names><![CDATA[Braulia Aurelia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Médico ABC  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>38</volume>
<numero>6</numero>
<fpage>439</fpage>
<lpage>443</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092024000600439&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092024000600439&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092024000600439&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[resumen está disponible en el texto completo]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Acute respiratory distress syndrome (ARDS) is a common critical condition in patients admitted to the Intensive Care Unit (ICU), characterized by a widespread inflammatory response and diffuse alveolar damage, leading to severe respiratory failure. Mortality associated with ARDS can exceed 40%, especially in the most severe cases. One of the most frequent complications of ARDS is acute kidney injury (AKI), a rapid deterioration of renal function that contributes to increased mortality and prolonged hospital stays. Interleukin 6 (IL-6) is a proinflammatory cytokine implicated in the systemic inflammatory cascade and organ damage, including the kidneys. However, the role of IL-6 as a biomarker in the development of AKI in patients with severe ARDS remains an area of debate, with previous studies showing mixed results. This study aims to evaluate whether serum levels of IL-6 upon admission can predict the development of AKI in patients with severe ARDS, with the goal of contributing to a better understanding of its clinical value in this critical population.  Objectives:  To determine whether elevated serum levels of IL-6 upon ICU admission are associated with the development of AKI in patients with severe ARDS. Additionally, to assess the predictive performance of IL-6 for the development of AKI.  Material and methods:  A retrospective cohort study was conducted in a sample of 98 adult patients diagnosed with severe ARDS, admitted to the ICU at ABC Medical Center between March 2020 and March 2024. Serum levels of IL-6 and creatinine were measured upon admission and at 48 and 72 hours later. Statistical analysis was performed using normality tests and logistic regression analysis to evaluate the association between IL-6 and AKI, as well as ROC curve analysis to assess the predictive performance of IL-6.  Results:  Of the 98 patients, 39.8% (n = 39) developed AKI. The mean age of the patients was 61.5 ± 18.0 years, and AKI was significantly associated with age (p &lt; 0.05), but not with sex. Regarding IL-6 levels upon admission, no statistically significant association was found with the development of AKI (OR: 1.0004; 95%CI 0.999-1.001). ROC curve analysis for IL-6 showed an area under the curve of 0.568 (p = 0.259), indicating a low predictive value for AKI. However, a positive and significant correlation was observed between IL-6 levels and creatinine concentrations at 72 hours (rho = 0.278, p = 0.006), suggesting a possible relationship with renal dysfunction in later stages.  Conclusions:  Although serum IL-6 levels upon admission did not prove to be a significant predictor of AKI development in patients with severe ARDS, the correlation observed between IL-6 and creatinine concentrations at 72 hours suggests that IL-6 may play a role in monitoring renal function at later stages. These findings suggest that IL-6 alone is not sufficient to predict AKI upon admission, but its measurement may complement other renal function markers for the clinical follow-up of these patients. Further studies are needed to explore the role of IL-6 in the evolution of AKI and its potential use as a marker in the management of renal function in critically ill patients.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução:  A Síndrome do Desconforto Respiratório Agudo (SDRA) é uma condição crítica comum em pacientes internados na Unidade de Terapia Intensiva (UTI), caracterizada por uma resposta inflamatória generalizada e dano alveolar difuso, levando à insuficiência respiratória grave. A mortalidade associada à SDRA pode exceder 40%, especialmente em casos graves. Entre as complicações mais comuns da SDRA está a lesão renal aguda (LRA), uma rápida deterioração da função renal que contribui para o aumento da mortalidade e prolonga a permanência no hospital. A interleucina-6 (IL-6) é uma citocina pró-inflamatória que tem sido implicada na cascata inflamatória sistêmica e na lesão de órgãos, inclusive nos rins. No entanto, a função da IL-6 como biomarcador no desenvolvimento de LRA em pacientes com SDRA grave continua sendo uma área de debate, com estudos anteriores mostrando resultados mistos. Este estudo visa avaliar se os níveis séricos de IL-6 na admissão podem prever o desenvolvimento de LRA em pacientes com SDRA grave, com o objetivo de contribuir para uma melhor compreensão de seu valor clínico nessa população crítica.  Objetivos:  Determinar se os níveis séricos elevados de IL-6 na admissão à UTI estão associados ao desenvolvimento de LRA em pacientes com SDRA grave. Além disso, avaliar o desempenho preditivo da IL-6 para o desenvolvimento de LRA.  Material e métodos:  Foi realizado um estudo de coorte histórico em uma amostra de 98 pacientes adultos com diagnóstico de SDRA grave internados na UTI do Centro Médico ABC entre março de 2020 e março de 2024. Os níveis séricos de IL-6 e creatinina foram medidos na admissão, 48 e 72 horas depois. A análise estatística foi realizada usando testes de normalidade e análise de regressão logística para avaliar a associação entre IL-6 e LRA, bem como análise de curva ROC para avaliar o desempenho preditivo da IL-6.  Resultados:  Dos 98 pacientes, 39.8% (n = 39) desenvolveram LRA. A idade média dos pacientes foi de 61.5 anos (DP 18.0), e a LRA foi significativamente associada à idade (p &lt; 0.05), mas não ao sexo. Quanto aos níveis de IL-6 na admissão, não foi encontrada nenhuma associação estatisticamente significativa com o desenvolvimento de LRA (RM: 1.0004; IC95% 0.999, 1.001). A análise da curva ROC para IL-6 mostrou uma área sob a curva de 0.568 (p = 0.259), indicando um baixo valor preditivo para LRA. No entanto, foi observada uma correlação positiva e significativa entre os níveis de IL-6 e as concentrações de creatinina em 72 horas (rho = 0.278, p = 0.006), sugerindo uma possível relação com a disfunção renal em estágios mais avançados.  Conclusões:  Embora os níveis séricos de IL-6 na admissão não tenham se mostrado um preditor significativo do desenvolvimento de LRA em pacientes com SDRA grave, a correlação observada entre as concentrações de IL-6 e creatinina em 72 horas indica que a IL-6 pode ter um papel no monitoramento da função renal em estágios posteriores. Esses achados sugerem que a IL-6 sozinha não é suficiente para prever a LRA na admissão, mas sua medição poderia complementar outros marcadores de função renal para o acompanhamento clínico desses pacientes. São necessários mais estudos para explorar o papel da IL-6 na evolução da LRA e seu possível uso como um marcador no manejo da função renal em pacientes em estado crítico.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[interleucina 6]]></kwd>
<kwd lng="es"><![CDATA[lesión renal aguda]]></kwd>
<kwd lng="es"><![CDATA[síndrome de dificultad respiratoria aguda]]></kwd>
<kwd lng="es"><![CDATA[biomarcador]]></kwd>
<kwd lng="en"><![CDATA[interleukin 6]]></kwd>
<kwd lng="en"><![CDATA[acute kidney injury]]></kwd>
<kwd lng="en"><![CDATA[respiratory distress syndrome]]></kwd>
<kwd lng="en"><![CDATA[biomarker]]></kwd>
<kwd lng="pt"><![CDATA[interleucina 6]]></kwd>
<kwd lng="pt"><![CDATA[lesão renal aguda]]></kwd>
<kwd lng="pt"><![CDATA[síndrome do desconforto respiratório agudo]]></kwd>
<kwd lng="pt"><![CDATA[biomarcador]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Matthay]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Zemans]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The acute respiratory distress syndrome: pathogenesis and treatment]]></article-title>
<source><![CDATA[J Clin Invest]]></source>
<year>2011</year>
<volume>121</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>4628-35</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bellani]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Laffey]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Pham]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>2016</year>
<volume>315</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>788-800</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hu]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[He]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association between acute respiratory distress syndrome and acute kidney injury: a systematic review and meta-analysis]]></article-title>
<source><![CDATA[Crit Care Med]]></source>
<year>2019</year>
<volume>47</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>e232-40</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<collab>Kidney Disease: Improving Global Outcomes (KDIGO)</collab>
<article-title xml:lang=""><![CDATA[KDIGO clinical practice guideline for acute kidney injury]]></article-title>
<source><![CDATA[Kidney Int Suppl]]></source>
<year>2012</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-138</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Koyner]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Nadim]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute kidney injury in patients with acute respiratory distress syndrome: epidemiology, outcomes, and management]]></article-title>
<source><![CDATA[Curr Opin Crit Care]]></source>
<year>2018</year>
<volume>24</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>477-84</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dinarello]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Proinflammatory cytokines]]></article-title>
<source><![CDATA[Chest]]></source>
<year>2000</year>
<volume>118</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>503-8</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Van der Poll]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Van de Veerdonk]]></surname>
<given-names><![CDATA[FL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The role of IL-6 in the pathogenesis of acute kidney injury]]></article-title>
<source><![CDATA[Crit Care]]></source>
<year>2012</year>
<volume>16</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>330</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ménard]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Role of interleukin-6 in inflammation and acute kidney injury]]></article-title>
<source><![CDATA[Curr Opin Nephrol Hypertens]]></source>
<year>2012</year>
<volume>21</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>565-9</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Interleukin-6 as a predictor of acute kidney injury in patients with sepsis]]></article-title>
<source><![CDATA[Crit Care]]></source>
<year>2018</year>
<volume>22</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>101</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jiang]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Xu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The association between interleukin-6 and acute kidney injury: a meta-analysis]]></article-title>
<source><![CDATA[Ren Fail]]></source>
<year>2020</year>
<volume>42</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>73-82</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
