Patients with Sepsis‑associated acute kidney injury undergoing continuous renal replacement therapy in the intensive care unit: epidemiology, clinical features, and early prognosis

Abstract Purpose Sepsis is the most common cause of acute kidney injury (AKI) in critical illness, but information on sepsis‑associated acute kidney injury (SA-AKI) is limited. The aim of this study was to describe the epidemiology, clinical features, and early prognosis of SA-AKI. Methods This was a single-center retrospective study that included critically ill patients treated with CRRT at the Affiliated Wuxi People' s Hospital of Nanjing Medical University, classified as patients with and without SA-AKI according to the definition of the Acute Disease Quality Initiative (ADQI). Results A total of 108 individuals met the inclusion criteria, including 59 SA-AKI patients and 49 non-SA-AKI patients from different general wards. The SA-AKI patients were older 60.0 (51.0–72.0) years vs. 73.0 (65.0–78.0) years, P < .05 and had higher APACHE II 21 (19–25) vs. 11 (15–17), P < .05 and SOFA scores 12 (11–14) vs.8 (7–9), P < .05. During ICU stay, SA-AKI patients had longer duration of mechanical ventilation 11 (4–23) days vs. 4 (1–10) days, P < .05 a, longer ICU stay 13 (6.5–24) days vs. 8 (5–16) days, P < .05, and significantly higher 28-day mortality rate 35 (59.3%) vs. 14 (28.6%), P < .05, which was about twice that of non-SA-AKI patients. SA-AKI patients' age (HR,0.978; 95%CI 0.957-1.000; P < .05) and lactate level (HR,1.146; 95%CI 1.018–1.291; P < .05) were independent risk factors for 28-day mortality. Conclusions Patients with SA-AKI treated with CRRT require longer duration of therapy and still face a poorer situation in terms of early prognosis and recovery of renal function, especially in patients of advanced age and hyperlactatemia.