Acute kidney injury in patients with sepsis: a contemporary analysis

Lopes, José António; Jorge, Sofía; Resina, Cristina; Santos, Carlos Pereira dos; Pereira, Álvaro; Neves, J.L.; Antúnes, Francisco; Prata, Mateus Martins

doi:10.1016/j.ijid.2008.05.1231

Cited by 87 publications

(81 citation statements)

References 24 publications

(31 reference statements)

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“…In Our study 55 patients were met AKIN criteria , 31% classified as stage 1, 54.5% classified as stage 2, 14.5% classified as stage 3, in our study increasing AKIN stages correlated with increasing mortality, 41.5%, 60%, and 62.5% in AKIN stage 1, stage 2, and stage 3 groups, respectively, this agrees with Lopes et al [16] who found that mortality rate was in stage 1 (34.6%), in stage 2 (45%), and in stage 3(64.1%). When comparing corresponding degrees of AKI according to AKIN and RIFLE (stage 1versus 'risk'; stage 2versus 'injury'; stage 3 versus 'failure') no difference in mortality.…”

Section: Outcomesupporting

confidence: 91%

Epidemiology, Clinical Characteristics and Outcome of Acute Kidney Injury in Intensive Care Units of Alexandria University Hospitals

Shafie¹

2016

UNOAJ

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Background: Acute kidney injury (AKI) considered as a major public health problem that affects millions of patients worldwide and leads to decreased survival and increased progression of chronic kidney disease (CKD).Aim of study: Epidemiology, clinical characteristics and outcome of acute kidney injury in patients admitted to main Alexandria university hospitals over six months. Methods:All patients who were admitted to intensive care units (ICUs) at Alexandria University Hospitals were prospectively studied. Patients who developed ICU-acquired acute renal failure were collected in the period over six months.Results: Our study included 500 patients in general ICU. General ICU patients classified according to renal impairment: 303 cases (no AKI) 60.6%, 74 cases (CKD) 14.8%, 55 cases (AKI) 11%, 38 cases (acute on top of CKD) 7.6%, 28 cases (ESRD) 5.6%, 2 cases (obstructive uropathy) 0.4%. Bimodal distribution of age in patients developed AKI at (18-30y) & (62-85y). 75 Toxicological cases, 3 developed AKI (2 organo phosphorus & 1 scorpion bite). The most common cause of AKI in our study was septic AKI 60% & among 128 cases of sepsis 32% not developed AKI/ 25.8% developed septic AKI 32% acute on top of CKD/10.2% ESRD. Mortality rate allover general ICU patients was 140/500 (28%) while allover AKI patients in general ICU 30/55(54%) and allover septic AKI 26/33(79%). Conclusion:AKI is a worsening problem, but its true incidence is in need of huge work, our work was 1 st up to our knowledge in Alexandria to check its incidence hence planning for better outcome.

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Section: Outcomesupporting

confidence: 91%

Epidemiology, Clinical Characteristics and Outcome of Acute Kidney Injury in Intensive Care Units of Alexandria University Hospitals

Shafie¹

2016

UNOAJ

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“…Lopes et al [23] conducted a retrospective study of a cohort of 315 patients with sepsis admitted to the infectious diseases ICU to determine the impact of AKI during ICU admission and found that AKI had a negative impact on in-hospital mortality of patients with sepsis. As compared with patients without acute renal impairment, patients with AKI had a 25.3% increased probability of death.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection

et al. 2011

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IntroductionLittle information exists about the impact of acute kidney injury (AKI) in critically ill patients with the pandemic 2009 influenza A (H1N1) virus infection.MethodsWe conducted a prospective, observational, multicenter study in 148 Spanish intensive care units (ICUs). Patients with chronic renal failure were excluded. AKI was defined according to Acute Kidney Injury Network (AKIN) criteria.ResultsA total of 661 patients were analyzed. One hundred eighteen (17.7%) patients developed AKI; of these, 37 (31.4%) of the patients with AKI were classified as AKI I, 15 (12.7%) were classified as AKI II and 66 (55.9%) were classified as AKI III, among the latter of whom 50 (75.7%) required continuous renal replacement therapy. Patients with AKI had a higher Acute Physiology and Chronic Health Evaluation II score (19.2 ± 8.3 versus 12.6 ± 5.9; P < 0.001), a higher Sequential Organ Failure Assessment score (8.7 ± 4.2 versus 4.8 ± 2.9; P < 0.001), more need for mechanical ventilation (MV) (87.3% versus 56.2%; P < 0.01, odds ratio (OR) 5.3, 95% confidence interval (CI) 3.0 to 9.4), a greater incidence of shock (75.4% versus 38.3%; P < 0.01, OR 4.9, 95% CI, 3.1 to 7.7), a greater incidence of multiorgan dysfunction syndrome (92.4% versus 54.7%; P < 0.01, OR 10.0, 95% CI, 4.9 to 20.21) and a greater incidence of coinfection (23.7% versus 14.4%; P < 0.01, OR 1.8, 95% CI, 1.1 to 3.0). In survivors, patients with AKI remained on MV longer and ICU and hospital length of stay were longer than in patients without AKI. The overall mortality was 18.8% and was significantly higher for AKI patients (44.1% versus 13.3%; P < 0.01, OR 5.1, 95% CI, 3.3 to 7.9). Logistic regression analysis was performed with AKIN criteria, and it demonstrated that among patients with AKI, only AKI III was independently associated with higher ICU mortality (P < 0.001, OR 4.81, 95% CI 2.17 to 10.62).ConclusionsIn our cohort of patients with H1N1 virus infection, only those cases in the AKI III category were independently associated with mortality.

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“…Sepsis-Associated Acute Kidney Injury (SA-AKI) is associated with worsened outcomes including longer hospital stays, greater disturbance in hemodynamics and laboratory parameters, and higher healthcare costs when compared to septic patients without kidney injury [3,4]. The severity of sepsis increased the incidence of AKI in a stepwise pattern [5,6]. In comparison with non-septic AKI, patients with SA-AKI carries greater severity of illness, indicating by higher Sequential Organ Failure Assessment (SOFA) scores [1], and require more hemodynamic supports with vasoactive agents and more aggressive fluid resuscitation [1,7,8].…”

Section: Sepsis-associated Acute Kidney Injurymentioning

confidence: 99%

Sepsis and Renal Replacement Therapy

Boongird¹

2017

J Clin Nephrol Ren Care

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Acute kidney injury in patients with sepsis: a contemporary analysis

Abstract: AKIN criteria are a useful tool to characterize and stratify septic patients according to the risk of death.

Cited by 87 publications

References 24 publications

Epidemiology, Clinical Characteristics and Outcome of Acute Kidney Injury in Intensive Care Units of Alexandria University Hospitals

Epidemiology, Clinical Characteristics and Outcome of Acute Kidney Injury in Intensive Care Units of Alexandria University Hospitals

Acute kidney injury in critical ill patients affected by influenza A (H1N1) virus infection

Sepsis and Renal Replacement Therapy

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