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Rational: Septic acute kidney injury (AKI) is a prevalent complication in intensive care units with an increased incidence of complications.Objective: The aim of the present study was to assess the use of high-resolution melting curve (HRM) analysis in investigating whether the genetic polymorphisms; –308 G/A of tumor necrosis factor-α (TNF-α), and –1082 G /A of Interleukin-10 (IL-10) genes may predispose patients diagnosed with severe sepsis to the development of AKI.Methods: One hundred and fifty patients with severe sepsis participated in the present study; only sixty-six developed AKI. Both polymorphisms were studied using HRM analysis.Main findings: The low producer genotype of both studied polymorphism of TNF-α and IL-10 genes was associated with AKI. Using logistic regression analysis, the low producer genotypes remained an independent risk factor for AKI. A statistically significant difference was detected between both studied groups as regards the low producer genotype in both TNF-α (–308 G/A) and interleukin-10 (IL-10) (–1082 G/A) polymorphisms being prevalent in patients developing AKI.Principle conclusions: The low producer genotypes of both TNF-α (–308 G/A) and IL-10 (–1082 G/A) polymorphisms could be considered a risk factor for the development of AKI in critically ill patients with severe sepsis, thus management technique implemented for this category should be modulated rescuing this sector of patients from the grave deterioration to acute kidney injury. Using HRM for genotyping proved to be a highly efficient, simple, cost-effective genotyping technique that is most appropriate for the routine study of large-scale samples.

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Context:The partial pressure of venous to arterial carbon dioxide gradient (PCO2 gap) is considered as an alternative marker of tissue hypoperfusion and has been used to guide treatment for shock.Aims:The aim of this study was to investigate the prognostic value of venous-to-arterial carbon dioxide difference during early resuscitation of patients with septic shock and compared it with that of lactate clearance and Acute Physiology and Chronic Health Evaluation II (APACHE-II) score.Settings and Design:Forty patients admitted to one Intensive Care Unit were enrolled.Subjects and Methods:APACHE-II score was calculated on admission. An arterial blood gas, central venous, and lactate samples were obtained on admission and after 6 h, and lactate clearance was calculated. Patients were classified retrospectively into Group I (survivors) and Group II (nonsurvivors). Pv-aCO2 difference in the two groups was evaluated.Statistical Analysis Used:Data were fed to the computer and analyzed using IBM SPSS software package version 20.0.Results:At T0, Group II showed high PCO2 gap (8.37 ± 1.36 mmHg) than Group I (7.55 ± 0.95 mmHg) with statistically significant difference (P = 0.030). While at T6, Group II showed higher PCO2 gap (9.48 ± 1.47 mmHg) with statistically significant difference (P < 0.001) and higher mean lactate values (62.71 ± 23.66 mg/dl) with statistically significant difference (P < 0.001) than Group I where PCO2 gap and mean lactate values became much lower, 5.91 ± 1.12 mmHg and 33.61 ± 5.80 mg mg/dl, respectively. Group I showed higher lactate clearance (25.42 ± 6.79%) with statistically significant difference (P < 0.001) than Group II (−69.40–15.46%).Conclusions:High PCO2 gap >7.8 mmHg after 6 h from resuscitation of septic shock patients is associated with high mortality.