Abstract:

[Abstact] Objective: To investigate clinical characteristics and outcomes of acute kidney injury (AKI) in patients with sepsis in a renal intensive care unit (RICU). Methodology: Three hundred twenty one patients were diagnosed as AKI and admitted to the RICU from July 2009 to January 2013. Among them, 32 cases with sepsis were enrolled this retrospective study. According to the clinical outcomes when they were discharged from RICU, they were divided into 3 groups: group I (n=5) was death, group II (n=9) was no improvement of renal function, and group III (n=18) was renal function improvement. Their clinical characteristics and outcomes were investigated. Results: 32 cases with sepsis were accupied 9.5% in a total of AKI patients in our RICU. They were 17 male and 15 female with the mean age of 47.4±18.9 years old. There were 21 cases with pre-existing CKD and receiving immunosuppressive therapy, 19 with respiratory tract infections, 14 with stage 3 AKI and 15 cases with septic shock on arrival at RICU. The renal replacement therapy was required in a total of 26 patients with AKI. There were 5 patients were dying (groupⅠ), and improvement of renal function were in 18 patients (group Ⅱ), and rest patients were group Ⅲ. Multivariable logistic regression analysis revealed that clinical outcomes were associated with the multiple organ dysfunction score (MODS), lactate levels and length of CRRT. Conclusion The proportions of patients in RICU who developed with septic AKI were relatively rare. The prevalence of pre-existing CKD and receiving immunosuppressive therapy was significantly higher in septic AKI patients. Primary infection foci were respiratory tract. Clinical outcomes were significantly associated with multiple organ dysfunction, lactate levels and length of CRRT.