Outcomes in Sepsis-Induced Acute Kidney Injury: A Prospective Observational Study
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 5
Abstract
Introduction: Acute Kidney injury (AKI) is often multifactorial, with sepsis being only one of the factors in its pathogenesis particularly in critically ill patients. It often leads to worse clinical outcomes, increased duration of hospitalization, need for intensive care and mortality. Our objective in the current study was to analyze the various factors associated with sepsis-related AKI and clinical outcome. Material and Methods: The study included all patients with sepsis admitted to medical Intensive care unit (ICU). These patients were subjected to laboratory investigations and radiological imaging. The APACHE II score was assessed and patients were grouped by RIFLE categories for risk, injury, and failure. Course in the hospital was observed for a period of 28 days or till discharge/death of the patients. Results: Of the 320 patients with sepsis, 31.2% developed AKI due to sepsis. The overall mortality rate of AKI patients with sepsis was 58%. The mortality rate increased significantly as renal function deteriorated (p=0.020). It was also observed that the mortality increased significantly with increase in the severity of sepsis (p<0.005). Multivariate logistic regression analysis revealed sepsis severity, RIFLE class, high APACHE II score were the independent predictors of mortality. Conclusion: The present study revealed high overall mortality rate. Males sex, sepsis severity, RIFLE class, high APACHE II score, and Vasopressor Use were the independent predictors of mortality in sepsis-induced AKI, while age had no independent prognostic value.
Authors and Affiliations
Ruchita Sharma, Amit Shukla, Ajay Kumar Mishra, Davendra Kumar, Mehboob Subhani Siddiqui, Abhishek Dixit
Keywords
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