Risk of Kidney Injury Requiring Dialysis After Sepsis

Abstract

Background:Sepsis-associated acute kidney injury (AKI) can accelerate the progression of chronic kidney disease and lead to permanent kidney damage. However, the relationship between sepsis-associated AKI and dialysis has not been well evaluated. Our study aimed to investigate the risk of AKI requiring dialysis after sepsis.Methods:A nationwide population-based case-crossover study comprised all patients requiring their first dialysis from 2004 to 2016 from the database of Taiwan’s National Health Insurance. Patients aged <20 years or with missing data were excluded.Results:147,201 and 75,031 patients requiring acute temporary and chronic dialysis were included in this study. The odds ratios (ORs) for patients requiring acute temporary dialysis after sepsis were 15.77, 10.67, 9.23, and 8.36 for exposure periods of 1, 2, 3, and 4 weeks, respectively. For patients requiring chronic dialysis after sepsis, ORs were 6.99, 4.12, 4.16, and 3.66 for exposure periods of 1, 2, 3, and 4 weeks, respectively. In analyses using no overlapping time intervals, the risk remained the highest during the time closest to the event.Conclusions: This study demonstrated that patients with sepsis had a markedly increased risk of renal failure requiring dialysis and the risk was highest within 1 week of sepsis.