B25-21 Chronic Kidney Disease in Sepsis Survivors: A 5-year Follow-up Study

Abstract Introduction Sepsis is a life-threatening illness often complicated by acute kidney injury (AKI). Survivors can develop chronic kidney disease (CKD) as a long-term sequela. However, the long-term renal outcomes after sepsis in patients with initial normal kidney function remain poorly characterized. We aimed to determine the five-year incidence of new-onset CKD in ICU patients with sepsis compared to matched ICU patients without sepsis. Methods We conducted a retrospective cohort study using the TriNetX Global Collaborative Network (a federal electronic health record network of 158 healthcare organizations). Adults 18-60 years old with ICU admission, baseline eGFR 90 mL/min/1.73 m², no prior history of CKD were identified. Cohort A comprised patients with a sepsis diagnosis at ICU admission, and Cohort B included similar patients without sepsis. We compared five-year CKD incidence between cohorts, calculating risk ratios (RR) with 95% confidence intervals. Time-to-event outcomes were assessed with Kaplan-Meier survival curves (log-rank test) and Cox proportional hazards models. A “number of instances” analysis also evaluated the mean count of CKD diagnoses in each cohort. Results After propensity matching, 7,391 patients were matched to each cohort. The 5-year cumulative incidence of new-onset CKD was 1.2% among patients in cohort 1 (sepsis) compared with 0.6%among patients in cohort 2 (non-sepsis), with a risk ratio of 2.154 (95% CI, 1.49-3.12). The mean number of CKD episodes per patient was significantly higher in the sepsis cohort than in those without sepsis (0.032 ± 0.516 vs 0.015 ± 0.273; p = 0.013), suggesting a greater cumulative kidney disease burden following sepsis. At the end of the follow-up period, both cohorts had good survival, but it was lower in the sepsis group (95.6% vs. 98.2%). Conclusions ICU patients with sepsis had a significantly higher 5-year risk of developing CKD than matched ICU patients without sepsis. Even when admission eGFR was normal, sepsis appears to confer lasting renal vulnerability. These findings highlight the need for long-term renal surveillance in sepsis survivors. This abstract is funded by: “None”