BACKGROUND 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/m²). 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.
BACKGROUND AND OBJECTIVES:Acute kidney injury (AKI) is a frequent complication in critically illpatients 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/m²). 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.
Authors: Sami Safadi; Musab S Hommos; Felicity T Enders; John C Lieske; Kianoush B Kashani Journal: Mayo Clin Proc Date: 2020-01-31 Impact factor: 7.616
Authors: Joseph L Alge; Nithin Karakala; Benjamin A Neely; Michael G Janech; James A Tumlin; Lakhmir S Chawla; Andrew D Shaw; John M Arthur Journal: Clin J Am Soc Nephrol Date: 2012-11-08 Impact factor: 8.237
Authors: Marlene E Starr; Hitoshi Takahashi; Daiki Okamura; Brittany A Zwischenberger; Amy A Mrazek; Junji Ueda; Arnold J Stromberg; B Mark Evers; Charles T Esmon; Hiroshi Saito Journal: Am J Physiol Heart Circ Physiol Date: 2014-11-07 Impact factor: 4.733
Authors: Christian Radke; Dagmar Horn; Christian Lanckohr; Björn Ellger; Michaela Meyer; Thomas Eissing; Georg Hempel Journal: Clin Pharmacokinet Date: 2017-07 Impact factor: 6.447