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Title: Septic acute kidney injury in critically ill patients: clinical characteristics and outcomes
Authors: Bagshaw, Sean M ×
Uchino, Shigehiko
Bellomo, Rinaldo
Morimatsu, Hiroshi
Morgera, Stanislao
Schetz, Miet
Tan, Ian
Bouman, Catherine
Macedo, Ettiene
Gibney, Noel
Tolwani, Ashita
Oudemans-van Straaten, Heleen M
Ronco, Claudio
Kellum, John A #
Issue Date: May-2007
Publisher: American Society of Nephrology
Series Title: Clinical journal of the American Society of Nephrology vol:2 issue:3 pages:431-9
Abstract: Sepsis is the most common cause of acute kidney injury (AKI) in critical illness, but there is limited information on septic AKI. A prospective, observational study of critically ill patients with septic and nonseptic AKI was performed from September 2000 to December 2001 at 54 hospitals in 23 countries. A total of 1753 patients were enrolled. Sepsis was considered the cause in 833 (47.5%); the predominant sources of sepsis were chest and abdominal (54.3%). Septic AKI was associated with greater aberrations in hemodynamics and laboratory parameters, greater severity of illness, and higher need for mechanical ventilation and vasoactive therapy. There was no difference in enrollment kidney function or in the proportion who received renal replacement therapy (RRT; 72 versus 71%; P = 0.83). Oliguria was more common in septic AKI (67 versus 57%; P < 0.001). Septic AKI had a higher in-hospital case-fatality rate compared with nonseptic AKI (70.2 versus 51.8%; P < 0.001). After adjustment for covariates, septic AKI remained associated with higher odds for death (1.48; 95% confidence interval 1.17 to 1.89; P = 0.001). Median (IQR) duration of hospital stay for survivors (37 [19 to 59] versus 21 [12 to 42] d; P < 0.0001) was longer for septic AKI. There was a trend to lower serum creatinine (106 [73 to 158] versus 121 [88 to 184] mumol/L; P = 0.01) and RRT dependence (9 versus 14%; P = 0.052) at hospital discharge for septic AKI. Patients with septic AKI were sicker and had a higher burden of illness and greater abnormalities in acute physiology. Patients with septic AKI had an increased risk for death and longer duration of hospitalization yet showed trends toward greater renal recovery and independence from RRT.
URI: 
ISSN: 1555-9041
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Intensive Care Medicine
× corresponding author
# (joint) last author

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