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Observational Study
. 2013 Jul;54(4):965-72.
doi: 10.3349/ymj.2013.54.4.965.

Acute kidney injury in patients with sepsis and septic shock: risk factors and clinical outcomes

Sang Heon Suh  1 , Chang Seong Kim, Joon Seok Choi, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
Affiliations
Observational Study

Acute kidney injury in patients with sepsis and septic shock: risk factors and clinical outcomes

Sang Heon Suh et al. Yonsei Med J. 2013 Jul.

Abstract

Purpose: The aim of this study was to investigate clinical characteristics and risk factors of acute kidney injury (AKI) in patients with sepsis and septic shock. Additionally, we explored whether the severity of AKI affects on the clinical outcomes.

Materials and methods: Data were collected retrospectively in a single center. Among 5680 patients who visited emergency department from January to December 2010, 992 patients with sepsis and septic shock were enrolled. Patients were divided into two groups, patients who developed AKI or not, to compare the baseline characteristics, and laboratory and physiologic data. Patients with AKI were subdivided according to its stages for survival analysis.

Results: AKI was developed in 57.7% of patients. Multivariable logistic regression analysis revealed that development of septic AKI was associated with older age, pre-existing chronic kidney disease, use of angiotensin converting enzyme inhibitor or angiotensin receptor blocker, presence of shock, positive blood culture results, and low white blood cell and platelet counts. Hospital mortality was higher in AKI group. Crude Kaplan-Meier survival curves demonstrated reduced 30-day survival rate was significantly associated with the severity of acute kidney injury.

Conclusion: The development of septic AKI was associated with poor clinical outcomes. Furthermore, the severity of AKI was associated with increased mortality.

Keywords: Acute kidney injury; mortality; risk factors; sepsis; septic shock.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Study design. AKI, acute kidney injury.
Fig. 2
Fig. 2
Survival curves for 30 days. Kaplan-Meier survival for 30 days by AKI stages in patients with sepsis and septic shock demonstrated reduced survival rate was significantly associated with the severity of AKI (p<0.001 by log-rank test). AKI, acute kidney injury.
See this image and copyright information in PMC

References

    1. Cartin-Ceba R, Haugen EN, Iscimen R, Trillo-Alvarez C, Juncos L, Gajic O. Evaluation of "Loss" and "End stage renal disease" after acute kidney injury defined by the Risk, Injury, Failure, Loss and ESRD classification in critically ill patients. Intensive Care Med. 2009;35:2087–2095. - PubMed
    1. Hoste EA, Schurgers M. Epidemiology of acute kidney injury: how big is the problem? Crit Care Med. 2008;36(4 Suppl):S146–S151. - PubMed
    1. Bagshaw SM, Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M, et al. Septic acute kidney injury in critically ill patients: clinical characteristics and outcomes. Clin J Am Soc Nephrol. 2007;2:431–439. - PubMed
    1. Plataki M, Kashani K, Cabello-Garza J, Maldonado F, Kashyap R, Kor DJ, et al. Predictors of acute kidney injury in septic shock patients: an observational cohort study. Clin J Am Soc Nephrol. 2011;6:1744–1751. - PubMed
    1. Bagshaw SM, Lapinsky S, Dial S, Arabi Y, Dodek P, Wood G, et al. Acute kidney injury in septic shock: clinical outcomes and impact of duration of hypotension prior to initiation of antimicrobial therapy. Intensive Care Med. 2009;35:871–881. - PubMed

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