Association between gut microbiota and acute kidney injury in ICU patients: a Prospective Observational Cohort Study

Acute kidney injury (AKI) is a critical condition in intensive care unit (ICU) patients, associated with high morbidity and mortality. The gut microbiome, an emerging indicator of systemic health, may reflect and potentially influence host pathophysiology in critical illness.This study aimed to characterize the gut microbiota ecology in ICU patients and assess its association with the incidence of AKI and in-hospital mortality, independent of baseline disease severity. In a single-center observational study, we performed 16S ribosomal RNA sequencing on fecal samples from 70 ICU patients. We employed multivariate Cox regression to evaluate the association between gut microbiota features (Shannon diversity index [SDI] and taxonomic composition) and the development of AKI, adjusting for key clinical confounders including illness severity scores. The association between microbiota features and in-hospital mortality was assessed using Cox proportional-hazards analysis.