Clinical Characteristics and Outcomes of Septic Acute Kidney Injury in Critically Ill Patients

Abstract

Purpose: This study was to determine the clinical characteristics and outcomes of critically ill patients with septic acute kidney injury (AKI). Methods: We retrospectively collected data of patients with AKI who were ≥18 years of age and admitted to the intensive care unit (ICU) for ≥24 hours from April 2007 to December 2009, and compared the clinical characteristics and outcomes of patients with and without sepsis. Results: Of the 1,075 patients, 333 had AKI, as defined by the RIFLE criteria, and 134 of them had AKI with sepsis. Septic AKI had significantly higher SAPS II and SOFA scores, and required more mechanical ventilation and vasoactive drugs than non-septic AKI. Patients with septic AKI progressed more to the failure category of the RIFLE criteria. Patients with septic AKI had higher in-hospital mortality and required more RRT, compared to patients with non-septic AKI. Amongst survivors, patients with septic AKI were more likely to recover renal function. A higher SAPS II score and a greater requirement for vasoactive drugs and renal replacement therapy were independently associated with increased in-hospital mortality in septic AKI. Conclusion: Patients with septic AKI have a higher burden of illness with an increased risk of death, but renal function recovers better in survivors of septic AKI.