• Sílvia Coelho, Margarida Monteiro, Joana Santos, Francisco Correia, Patrícia Rodrigues, Matilde Rito, and Paulo Freitas.
• Intensive Care Department, Hospital Fernando Fonseca EPE, Amadora, Portugal; CEDOC- Chronic Diseases Research Center, NOVA Medical School, NOVA University of Lisbon, Portugal. Electronic address: silvia.coelho.nephro@gmail.com.
• J Crit Care. 2021 Aug 1; 64: 1-6.

IntroductionThe role of immunological mechanisms on renal regeneration and functional recovery after an episode of Acute Kidney Injury (AKI) is still understudied. We aim to evaluate the impact of sterile leukocyturia on outcomes of critically-ill AKI patients.MethodsA retrospective analysis of critically-ill patients with stage ≥2 AKI by KDIGO was performed. Patients with urinary tract infection, previous renal replacement therapy, chronic kidney disease stage >3 and kidney, urinary tract or prostatic cancer were excluded. Sterile leukocyturia was defined as a positive leukocyte esterase value.Results108 patients with stage ≥2 AKI were included, 39.8% of which had sterile leukocyturia. AKI patients with sterile leukocyturia were older, had more cardiovascular disease and a lower baseline renal function (p < 0.05). They had a higher serum creatinine and leukocytosis at admission, were more frequently septic (p < 0.05) and had more persistent AKI by both KDIGO criteria at multivariable analysis (OR 6.130, 95% CI 2.007-18.747).ConclusionSterile leukocyturia was associated with different patient baseline and AKI characteristics and more persistent AKI by both KDIGO criteria. Sterile leukocyturia may represent a surrogate marker of renal inflammation during AKI.Copyright © 2021 Elsevier Inc. All rights reserved.

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