Renal involvement in sepsis: A prospective single-center study of 136 cases

Shah, PR; Gireesh, M. S.; Kute, Vivek B.; Vanikar, Aruna V; Gumber, Manoj R.; Patel, Himanshu V.; Goplani, Kamal R; Trivedi, Hargovind L

doi:10.4103/1319-2442.111089

Cited by 8 publications

(2 citation statements)

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“…[20] However, a study in India by Shah et al ., found urogenital infection to be the most common source of sepsis in patients who developed AKI. [27] Acute GE was the second most common cause of AKI in our study. The higher number might be attributed to the fact that our institution is a tertiary care center, managing patients referred after developing renal complications.…”

Section: Discussionmentioning

confidence: 73%

Spectrum of acute kidney injury in critically ill patients: A single center study from South India

Eswarappa¹,

Gireesh²,

Ravi³

et al. 2014

Indian J Nephrol

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Acute kidney injury (AKI) is common in intensive care unit (ICU) and carries a high mortality rate. Reliable and comparable data about the clinical spectrum of AKI is necessary for optimizing management. The study was conducted to describe epidemiology, etiology, clinical characteristics and outcome of AKI in critically ill patients without pre-existing renal disease, diagnosed using RIFLE criteria. We retrospectively analyzed data of 500 adult patients admitted to ICU with AKI or who developed AKI in ICU. Patients with pre-existing renal disease, renal transplant recipients were excluded. AKI was predominantly encountered in older males. Diabetes, hypertension, coronary artery disease were the most commonly prevalent comorbidities. Sepsis was the most common cause of AKI, accounting for 38.6% of patients. 24.4% belonged to risk class, 37.0% to injury class, 35.0% to failure class, 3% to loss and 0.6% to ESRD class of the RIFLE criteria. Renal replacement therapy (RRT) was required in 37.2% (n = 186) of patients. About 60% recovered complete renal function. Chronic kidney disease (CKD) was a sequel in 2.4% (n = 12) of patients. Average duration of ICU stay was 5.6 days. Crude mortality rate was 37.6% (n = 188). In critically ill patients without pre-existing renal disease, elderly age, male sex, type 2 diabetes along with a primary diagnosis of sepsis were most commonly associated with AKI. Majority of the patients’ recovered complete renal function.

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Section: Discussionmentioning

confidence: 73%

Spectrum of acute kidney injury in critically ill patients: A single center study from South India

Eswarappa¹,

Gireesh²,

Ravi³

et al. 2014

Indian J Nephrol

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“…Hemodynamic changes in sepsis may predispose the elderly to acute kidney injury (AKI), especially if they have underlying chronic kidney disease (CKD) [ 41 ] . Most common renal manifestation of sepsis is AKI [ 42 ] . In a study by Romao et al, sepsis in itself or in combination with other factors such as hypotension and nephrotoxic medications was responsible for AKI in the elderly [ 43 ] .…”

Section: Clinical Conundrums and Challenges In Management Of Sepsismentioning

confidence: 99%

Clinical conundrums in management of sepsis in the elderly

Sehgal

Bajwa

Consalvo

et al. 2015

Journal of Translational Internal Medicine

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In 2012, surviving sepsis campaign came out with updated international guidelines for management of severe sepsis and septic shock. Paradoxically, there are no specific guidelines for management of sepsis in the elderly, although the elderly are more predisposed to sepsis, and morbidity and mortality related to sepsis. Sepsis in the elderly is, more often than not, complicated by clinical conundrums such as congestive heart failure (CHF), atrial fibrillation (AF), chronic kidney disease (CKD), acute kidney injury (AKI), delirium, dementia, ambulatory dysfunction, polypharmacy, malglycemia, nutritional deficiencies, and antibiotic resistance. Also, with recurrent admissions to the hospital and widespread use of antibiotics, the elderly are more susceptible to Clostridium difficile colitis.

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