Acute renal failure in patients with sepsis

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

doi:10.1186/cc5735

Cited by 66 publications

(48 citation statements)

References 3 publications

(1 reference statement)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17,[39][40][41]51 Interestingly; however, compared with non-septic AKI, survivors of septic may have a greater likelihood of renal recovery and independence from RRT. 40,52 Cardio-renal syndrome Kidney and cardiac disease are common, increasingly prevalent, and frequently co-exist. 53 Evidence has accrued to show that acute/chronic cardiac disease can contribute directly to acute/chronic worsening kidney function and vice versa.…”

Section: Syndromes Of Acute Kidney Injurymentioning

confidence: 99%

Review article: Acute kidney injury in critical illness

Bagshaw

Bellomo

Devarajan

et al. 2010

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose This review provides a focused and comprehensive update on emerging evidence related to acute kidney injury (AKI).Principal findings Acute kidney injury is a significant clinical problem that increasingly complicates the course of hospitalization and portends worse clinical outcome for sick hospitalized patients. The recent introduction of consensus criteria for the diagnosis of AKI (i.e., RIFLE/AKIN classification) have greatly improved our capacity not only to standardize the diagnosis and classification of severity of AKI, but also to facilitate conducting comparative epidemiologic studies in an effort to better understand the burden of adult and pediatric AKI and its syndromes (i.e., septic, cardio-renal, hepato-renal). The characterization of several novel AKI-specific biomarkers (i.e., neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, and interleukin-18) is extending our understanding of the pathophysiology of AKI. Moreover, these biomarkers appear to have clinical relevance for early detection and they provide prognostic value. These innovations are aiding in the design of epidemiologic surveys and randomized trials of therapeutic interventions. Strategies for prevention Editor's Note: This article is the first of two linked special review articles published in this issue of the Journal. The concept of these articles emerged from the scientific content of the 2010 Acute Kidney Injury (AKI) and Renal Support in Critical Illness Symposium, hosted in Edmonton, Alberta. This review (Part 1) provides a focused and comprehensive update on emerging evidence in the diagnosis and classification of AKI, on specific AKI syndromes, and on the prevention and conservative management of hospitalized patients with AKI. Abstracts presented at this meeting were selected on the basis of peer review by the Scientific Committee and were accepted for presentation at the AKI 2010 Symposium, and appear as Electronic Supplementary Material at

show abstract

Section: Syndromes Of Acute Kidney Injurymentioning

confidence: 99%

Review article: Acute kidney injury in critical illness

Bagshaw

Bellomo

Devarajan

et al. 2010

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…While the etiology of AKI in critically ill patients is likely often multi-factorial, sepsis has consistently been found an important contributing factor [28][29][30][31][32][33][34]. In a retrospective analysis of critically ill patients admitted to 57 ICU across Australia, Bagshaw et al found that of those admitted with a primary septic diagnosis, 42.1% had concomitant AKI on day one [28].…”

Section: Septic Akimentioning

confidence: 99%

Epidemiology of Septic Acute Kidney Injury

Parmar

Langenberg

Wan

et al. 2009

CDT

View full text Add to dashboard Cite

The incidence of sepsis and acute kidney injury (AKI) are increasing in critically ill patients and both portend a higher risk of morbidity and death. Sepsis has consistently been shown to be a key contributing factor for the development of AKI. Numerous observational studies have found septic AKI to be highly common among the critically ill. Septic AKI patients are characterized by important differences in baseline demographics, acuity of illness and treatment intensity when compared with non-septic AKI. In particular, these patients are often older, have a higher prevalence of co-morbid illnesses, and are admitted for medical or emergency surgical indications. These patients show greater aberrancy in vital signs, laboratory parameters and need for vasoactive therapy and/or mechanical ventilation. Delays in initiation of appropriate antimicrobial therapy independently predict development of AKI in septic patients. Both delays to appropriate antimicrobials and initiation of renal support are also associated with higher mortality. Survival to ICU and/or hospital discharge for septic AKI patients is significantly lower when compared to patients with either non-septic AKI or sepsis alone. However, survivors of septic AKI show trends for greater rates of renal recovery and dialysis independence compared with non-septic AKI. The burden of septic AKI continues to increase and remains associated with an unacceptably high attributable morbidity and mortality. Accordingly, there is continued need to understand its epidemiology, not only to guide in management of these patients at the bedside, but also to stimulate advances in understanding its pathophysiology and in therapeutic interventions to potentially mitigate prognosis.

show abstract

“…Half of AKI cases in critically ill patients are sepsis-related (4,7) and AKI develops in 31 to 65% of septic shock patients (5,8,9). Most importantly, AKI in septic patients is consistently linked to higher mortality rates and increased consumption of health care resources (5,8 -10).…”

Section: Introductionmentioning

confidence: 99%

Predictors of Acute Kidney Injury in Septic Shock Patients

Plataki¹,

Kashani²,

Cabello-Garza³

et al. 2011

Clinical Journal of the American Society of Nephrology

158

103

View full text Add to dashboard Cite

SummaryBackground and objectives Acute kidney injury (AKI) is a frequent complication in critically ill patients and sepsis is the most common contributing factor. We aimed to determine the risk factors associated with AKI development in patients with septic shock.Design, setting, participants, & measurements Observational cohort study consisted of consecutive adults with septic shock admitted to a medical intensive care unit (ICU) of a tertiary care academic hospital from July 2005 to September 2007. AKI was defined according to RIFLE criteria (urine output and creatinine criteria). Demographic, clinical, and treatment variables were reviewed. Main outcomes measured were AKI occurrence, all-cause hospital mortality, and hospital and ICU length of stay.Results Three hundred ninety patients met inclusion criteria, of which 237 (61%) developed AKI. AKI development was independently associated with delay to initiation of adequate antibiotics, intra-abdominal sepsis, blood product transfusion, use of angiotensin-converting enzyme inhibitor/angiotensin-receptor blocker, and body mass index (kg/m 2 ). Higher baseline GFR and successful early goal directed resuscitation were associated with a decreased risk of AKI. Hospital mortality was significantly greater in patients who developed AKI (49 versus 34%).Conclusions In a contemporary cohort of patients with septic shock, both patient and health care delivery risk factors seemed to be important for AKI development.

show abstract

Acute renal failure in patients with sepsis

Cited by 66 publications

References 3 publications

Review article: Acute kidney injury in critical illness

Review article: Acute kidney injury in critical illness

Epidemiology of Septic Acute Kidney Injury

Predictors of Acute Kidney Injury in Septic Shock Patients

Contact Info

Product

Resources

About