Volume 4, Issue 1 (Spring & Summer 2020)                   J Res Urol 2020, 4(1): 10-18 | Back to browse issues page


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Sabzghabaei F, Mahmoodi V, Pouladi M, Yassin Z, soltani P. Risk Factors of Acute Kidney Injury in Patients with Sepsis; A Cross-Sectional Study. J Res Urol 2020; 4 (1) :10-18
URL: http://urology.umsha.ac.ir/article-1-71-en.html
1- Department of Nephrology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2- Resident of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran , drdesperado58@gmail.com
3- Resident of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran
4- Antimicrobial Resistance Research Center, Iran University of Medical Sciences, Tehran, Iran
5- Medical doctor, Iran University of Medical Sciences, Tehran, Iran
Abstract:   (4470 Views)
Background and Objective: Due to the importance of acute kidney injury associated in patients with sepsis and the impact of various factors on mortality and hospital stay of these patients, this study was conducted to investigate the clinical features and risk factors for acute kidney injury in patients with sepsis. In addition, we examined whether the severity of acute kidney injury affected clinical outcomes.
Methods: This was a cross-sectional study performed on patients admitted with sepsis in Firoozgar Hospital between 2018 and 2020. Patients were divided into two groups, those with and without acute kidney injury, to compare baseline and laboratory characteristics. 
Results: In total, 380 patients entered. Acute kidney injury (AKI) occurred in 41.1% of patients with sepsis. Analysis of multivariate logistic regression showed that the risk of acute kidney injury significantly was associated with older age, history of ischemic heart disease, hypertension and diabetes, smoking and drug abuse, use of ACEI and ARB medications, presence of bacteremia, presence of tissue infection as sepsis etiology, low serum albumin, and high AST levels, delayed antibiotic and fluid therapy, and vasopressor administration. Hospital mortality and length of hospital stay were higher in the AKI group.
Conclusion: Septic AKI had a negative effect on clinical outcomes. Also, the severity of acute kidney injury was associated with increased short-term mortality, length of hospital stay, and the need for dialysis.
Full-Text [PDF 433 kb]   (1625 Downloads)    
Type of Study: Research | Subject: Endourology
Received: 2020/06/27 | Accepted: 2020/08/21 | Published: 2020/09/16

References
1. Borisov VV, Shilov EM. [Acute renal failure]. Urologiia (Moscow, Russia : 1999). 2017(1 Suppl 1):4-10. [DOI:10.18565/urol.2017.1-supplement.4-10] [PMID]
2. Levey AS, James MT. Acute Kidney Injury. Annals of internal medicine. 2017;167(9):ITC66-ITC80. [DOI:10.7326/AITC201711070] [PMID]
3. Koza Y. Acute kidney injury: current concepts and new insights. Journal of injury & violence research. 2016;8(1):58-62.
4. Ronco C, Bellasi A, Di Lullo L. Implication of Acute Kidney Injury in Heart Failure. Heart failure clinics. 2019;15(4):463-76. [DOI:10.1016/j.hfc.2019.05.002] [PMID]
5. Schefold JC, Filippatos G, Hasenfuss G, Anker SD, von Haehling S. Heart failure and kidney dysfunction: epidemiology, mechanisms and management. Nature reviews Nephrology. 2016;12(10):610-23. [DOI:10.1038/nrneph.2016.113] [PMID]
6. Kron IL, Joob AW, Van Meter C. Acute renal failure in the cardiovascular surgical patient. The Annals of thoracic surgery. 1985;39(6):590-8. [DOI:10.1016/S0003-4975(10)62011-5]
7. Lelubre C, Vincent JL. Mechanisms and treatment of organ failure in sepsis. Nature reviews Nephrology. 2018;14(7):417-27. [DOI:10.1038/s41581-018-0005-7] [PMID]
8. Husain-Syed F, Slutsky AS, Ronco C. Lung-Kidney Cross-Talk in the Critically Ill Patient. American journal of respiratory and critical care medicine. 2016;194(4):402-14. [DOI:10.1164/rccm.201602-0420CP] [PMID]
9. Villacres SM, Medar SS, Aydin SI. Acute Kidney Injury in Children With Acute Respiratory Failure. Clinical pediatrics. 2018;57(11):1340-8. [DOI:10.1177/0009922818779222] [PMID]
10. Srivastava P, Cronin CG, Scranton VL, Jacobson KA, Liang BT, Verma R. Neuroprotective and neuro-rehabilitative effects of acute purinergic receptor P2X4 (P2X4R) blockade after ischemic stroke. Experimental neurology. 2020;329:113308. [DOI:10.1016/j.expneurol.2020.113308] [PMID]
11. Tsuneyoshi S, Yamada S, Matsumoto H, Yamaguchi S, Wakisaka K, Ueki K, et al. Anti-glomerular basement membrane disease complicated with posterior reversible encephalopathy syndrome and subcortical cerebral hemorrhage: a case report and review of the literature. CEN case reports. 2020;9(3):278-84. [DOI:10.1007/s13730-020-00473-x] [PMID] [PMCID]
12. Pekkucuksen NT, Akcan Arikan A, Swartz SJ, Srivaths P, Angelo JR. Characteristics and Clinical Outcomes of Prolonged Continuous Renal Replacement Therapy in Critically Ill Pediatric Patients. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 2020;21(6):571-7. [DOI:10.1097/PCC.0000000000002290] [PMID]
13. Lu S, Wu H, Xu J, He Z, Li H, Ning C. SIKIAT1/miR-96/FOXA1 axis regulates sepsis-induced kidney injury through induction of apoptosis. Inflammation research : official journal of the European Histamine Research Society [et al]. 2020;69(7):645-56. [DOI:10.1007/s00011-020-01350-0] [PMID]
14. Tehrani FHE, Moradi M, Ghorbani N. Bacterial Etiology and Antibiotic Resistance Patterns in Neonatal Sepsis in Tehran during 2006-2014. Iran J Pathol. 2017;12(4):356. [DOI:10.30699/ijp.2017.27992]
15. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure-definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Critical care. 2004;8(4):R204.
16. Durand F, Graupera I, Gines P, Olson JC, Nadim MK. Pathogenesis of Hepatorenal Syndrome: Implications for Therapy. Am J Kidney Dis. 2016;67(2):318-28. [DOI:10.1053/j.ajkd.2015.09.013] [PMID]
17. Kheterpal S, Tremper KK, Heung M, Rosenberg AL, Englesbe M, Shanks AM, et al. Development and validation of an acute kidney injury risk index for patients undergoing general surgeryresults from a national data set. Anesthesiology. 2009;110(3):505-15. [DOI:10.1097/ALN.0b013e3181979440] [PMID]
18. Feest TG, Mistry CD, Grimes DS, Mallick NP. Incidence of advanced chronic renal failure and the need for end stage renal replacement treatment. BMJ. 1990;301(6757):897-900. [DOI:10.1136/bmj.301.6757.897] [PMID] [PMCID]
19. Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, et al. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294(7):813-8. [DOI:10.1001/jama.294.7.813] [PMID]
20. Klenzak J, Himmelfarb J. Sepsis and the kidney. Critical care clinics. 2005;21(2):211-22. [DOI:10.1016/j.ccc.2005.01.002] [PMID]
21. Moradi M, Ghosian MH, Yaghout poor E. Assessment of Hyoscyamus niger seeds alcoholic extract effects on acute and chronic pain in male NMRI rats. J Basic Clin Pathophysiol. 2012;1(1):29-36.
22. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29(7):1303-10. [DOI:10.1097/00003246-200107000-00002] [PMID]
23. Lafrance JP, Miller DR. Acute kidney injury associates with increased long-term mortality. J Am Soc Nephrol. 2010;21(2):345-52. [DOI:10.1681/ASN.2009060636] [PMID] [PMCID]
24. Wan L, Bagshaw SM, Langenberg C, Saotome T, May C, Bellomo R. Pathophysiology of septic acute kidney injury: what do we really know? Critical care medicine. 2008;36(4):S198-S203. [DOI:10.1097/CCM.0b013e318168ccd5] [PMID]
25. Plataki M, Kashani K, Cabello-Garza J, Maldonado F, Kashyap R, Kor DJ, et al. Predictors of acute kidney injury in septic shock patients: an observational cohort study. Clin J Am Soc Nephrol. 2011;6(7):1744-51. [DOI:10.2215/CJN.05480610] [PMID]
26. Bagshaw SM, Lapinsky S, Dial S, Arabi Y, Dodek P, Wood G, et al. Acute kidney injury in septic shock: clinical outcomes and impact of duration of hypotension prior to initiation of antimicrobial therapy. Intensive Care Med. 2009;35(5):871-81. [DOI:10.1007/s00134-008-1367-2] [PMID]
27. Neveu H, Kleinknecht D, Brivet F, Loirat P, Landais P, Failure FSGoAR. Prognostic factors in acute renal failure due to sepsis. Results of a prospective multicentre study. Nephrol Dial. 1996;11(2):293-9. [DOI:10.1093/oxfordjournals.ndt.a027256] [PMID]
28. Ricci Z, Ronco C. Pathogenesis of acute kidney injury during sepsis. Curr Drug Targets. 2009;10(12):1179-83. [DOI:10.2174/138945009789753192] [PMID]
29. Yohannes S, Chawla LS. Evolving practices in the management of acute kidney injury in the ICU (Intensive Care Unit). Clin Nephrol. 2009;71(6):602-7. [DOI:10.5414/CNP71602] [PMID]
30. Trzeciak S, McCoy JV, Dellinger RP, Arnold RC, Rizzuto M, Abate NL, et al. Early increases in microcirculatory perfusion during protocol-directed resuscitation are associated with reduced multi-organ failure at 24 h in patients with sepsis. Intensive Care Med. 2008;34(12):2210-7. [DOI:10.1007/s00134-008-1193-6] [PMID] [PMCID]
31. Langenberg C, Bagshaw SM, May CN, Bellomo R. The histopathology of septic acute kidney injury: a systematic review. Crit Care. 2008;12(2):R38. [DOI:10.1186/cc6823] [PMID] [PMCID]
32. Ahmed MH, Khalil AA. Obesity-related glomerulopathy: another nail in the coffin of the epidemic of end-stage renal disease. Journal of clinical pathology. 2007;60(5):582-. [DOI:10.1136/jcp.2006.040410] [PMID] [PMCID]
33. Druml W, Metnitz B, Schaden E, Bauer P, Metnitz PG. Impact of body mass on incidence and prognosis of acute kidney injury requiring renal replacement therapy. Intensive Care Med. 2010;36(7):1221-8. [DOI:10.1007/s00134-010-1844-2] [PMID]
34. Iglesias JI, DePalma JA, Levine JS. Risk factors for acute kidney injury following orthotopic liver transplantation: the impact of changes in renal function while patients await transplantation. BMC Nephrology. 2010;11(1):30. [DOI:10.1186/1471-2369-11-30] [PMID] [PMCID]
35. Bentley ML, Corwin HL, Dasta J. Drug-induced acute kidney injury in the critically ill adult: recognition and prevention strategies. Crit Care Med. 2010;38(6 Suppl):S169-74. [DOI:10.1097/CCM.0b013e3181de0c60] [PMID]
36. Pannu N, Nadim MK. An overview of drug-induced acute kidney injury. Crit Care Med. 2008;36(4 Suppl):S216-23. [DOI:10.1097/CCM.0b013e318168e375] [PMID]

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