Risk factors and mortality in patients with sepsis, septic and non septic acute kidney injury in ICU

Abstract Acute kidney injury (AKI) has an incidence rate of 5-6% among intensive care unit (ICU) patients and sepsis is the most frequent etiology. Aims: To assess patients in the ICU that developed AKI, AKI on chronic kidney disease (CKD), and/or sepsis, and identify the risk factors and outcomes of these diseases. Methods: A prospective observational cohort quantitative study that included patients who stayed in the ICU > 48 hours and had not been on dialysis previously was carried out. Results: 302 patients were included and divided into: no sepsis and no AKI (nsnAKI), sepsis alone (S), septic AKI (sAKI), non-septic AKI (nsAKI), septic AKI on CKD (sAKI/CKD), and non-septic AKI on CKD (nsAKI/CKD). It was observed that 94% of the patients developed some degree of AKI. Kidney Disease Improving Global Outcomes (KDIGO) stage 3 was predominant in the septic groups (p = 0.018). Nephrologist follow-up in the non-septic patients was only 23% vs. 54% in the septic groups (p摘要：急性肾损伤（Acute kidney injury, AKI）在重症监护病房（intensive care unit, ICU）患者中的发病率为5%~6%，脓毒症是其最常见的致病病因。研究目的：评估重症监护病房中罹患急性肾损伤、慢性肾脏病（chronic kidney disease, CKD）基础上的急性肾损伤以及（或）脓毒症的患者，并明确上述疾病的危险因素与预后转归。研究方法：本研究为前瞻性观察队列定量研究，纳入了ICU停留时长超过48小时且此前未接受过透析治疗的患者。研究结果：共纳入302例患者，分为以下6组：无脓毒症且无AKI组（nsnAKI）、单纯脓毒症组（S）、脓毒症相关AKI组（sAKI）、非脓毒症相关AKI组（nsAKI）、慢性肾脏病基础上的脓毒症相关AKI组（sAKI/CKD）以及慢性肾脏病基础上的非脓毒症相关AKI组（nsAKI/CKD）。观察发现，94%的患者出现了不同程度的急性肾损伤。改善全球肾脏病预后组织（Kidney Disease Improving Global Outcomes, KDIGO）3期AKI在脓毒症相关组别中占比最高（p = 0.018）。非脓毒症患者的肾内科随访率仅为23%，而脓毒症相关组别为54%（p