TY - JOUR
T1 - Predictors of Acute kidney injury in septic shock patients
T2 - An observational cohort study
AU - Plataki, Maria
AU - Kashani, Kianoush
AU - Cabello-Garza, Javier
AU - Maldonado, Fabien
AU - Kashyap, Rahul
AU - Kor, Daryl J.
AU - Gajic, Ognjen
AU - Cartin-Ceba, Rodrigo
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2011/7/1
Y1 - 2011/7/1
N2 - Background and objectives Acute kidney injury (AKI) is a frequent complication in critically ill patients and sepsis is the most common contributing factor. We aimed to determine the risk factors associated with AKI development in patients with septic shock. Design, setting, participants, & measurements Observational cohort study consisted of consecutive adults with septic shock admitted to a medical intensive care unit (ICU) of a tertiary care academic hospital from July 2005 to September 2007. AKI was defined according to RIFLE criteria (urine output and creatinine criteria). Demographic, clinical, and treatment variables were reviewed. Main outcomes measured were AKI occurrence, all-cause hospital mortality, and hospital and ICU length of stay. Results Three hundred ninety patients met inclusion criteria, of which 237 (61%) developed AKI. AKI development was independently associated with delay to initiation of adequate antibiotics, intra-abdominal sepsis, blood product transfusion, use of angiotensin-converting enzyme inhibitor/angiotensin-receptor blocker, and body mass index (kg/m2). Higher baseline GFR and successful early goal directed resuscitation were associated with a decreased risk of AKI. Hospital mortality was significantly greater in patients who developed AKI (49 versus 34%). Conclusions In a contemporary cohort of patients with septic shock, both patient and health care delivery risk factors seemed to be important for AKI development.
AB - Background and objectives Acute kidney injury (AKI) is a frequent complication in critically ill patients and sepsis is the most common contributing factor. We aimed to determine the risk factors associated with AKI development in patients with septic shock. Design, setting, participants, & measurements Observational cohort study consisted of consecutive adults with septic shock admitted to a medical intensive care unit (ICU) of a tertiary care academic hospital from July 2005 to September 2007. AKI was defined according to RIFLE criteria (urine output and creatinine criteria). Demographic, clinical, and treatment variables were reviewed. Main outcomes measured were AKI occurrence, all-cause hospital mortality, and hospital and ICU length of stay. Results Three hundred ninety patients met inclusion criteria, of which 237 (61%) developed AKI. AKI development was independently associated with delay to initiation of adequate antibiotics, intra-abdominal sepsis, blood product transfusion, use of angiotensin-converting enzyme inhibitor/angiotensin-receptor blocker, and body mass index (kg/m2). Higher baseline GFR and successful early goal directed resuscitation were associated with a decreased risk of AKI. Hospital mortality was significantly greater in patients who developed AKI (49 versus 34%). Conclusions In a contemporary cohort of patients with septic shock, both patient and health care delivery risk factors seemed to be important for AKI development.
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U2 - 10.2215/CJN.05480610
DO - 10.2215/CJN.05480610
M3 - Review article
C2 - 21734090
AN - SCOPUS:79960330280
SN - 1555-9041
VL - 6
SP - 1744
EP - 1751
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 7
ER -