Association between estimated pulse wave velocity and acute kidney injury in critically ill sepsis patients: A MIMIC-IV database analysis

The incidence of acute kidney injury (AKI) in patients undergoing coronary revascularization is significantly associated with estimated pulse wave velocity (ePWV). While many studies have confirmed the effect of ePWV on AKI, its significance in the progression of AKI among critically ill patients with sepsis remains unclear. This study utilized a retrospective cohort design using data from the Medical Information Mart for Intensive Care-IV database, which included adult intensive care unit patients with sepsis who were admitted for at least 48 hours. ePWV was derived from the patient's age and blood pressure. Participants were divided into 2 groups depending on whether they had AKI. The relationship between ePWV and AKI risk in sepsis patients was thoroughly assessed through univariate analysis, multivariate logistic regression, threshold effect analysis, and restricted cubic spline modeling. Analysis of the Medical Information Mart for Intensive Care-IV database showed that 66.1% of 18,351 sepsis patients developed AKI. In model 3, ePWV was significantly associated with AKI risk (odds ratio 1.02, 95% confidence interval: 1.01-1.03; P = .027). Restricted cubic spline analysis revealed a nonlinear dose-response relationship between ePWV and AKI risk (P for nonlinearity = .004). Threshold analysis identified an inflection point around 12.275 m/s, although estimates in the higher ePWV range should be interpreted cautiously. Subgroup analyses confirmed that this association remained stable and consistent across most of the subgroups. ePWV independently predicted AKI risk in patients with sepsis. This straightforward, noninvasive metric can facilitate early risk stratification and intervention.