News: Almost half of ICU sepsis patients also have sepsis-linked kidney injury, study finds

Nearly half of patients admitted to the intensive care unit (ICU) with sepsis are affected by sepsis-associated acute kidney injury (SA-AKI), with 25% dying during their hospital stay, according to an analysis recently published in Critical Care. SA-AKI was associated with higher mortality and increased risk of major adverse kidney events in patients than sepsis or acute kidney injury (AKI) alone, Medscape Medical News reported.

Researchers analyzed outcomes of over 180,000 adult patients admitted to the ICU at two academic centers between 2010 and 2022. Using the consensus definition of SA-AKI updated in 2023 to reflect Sepsis-3 criteria and Kidney Disease: Improving Global Outcomes criteria for AKI, they found 63,536 patients met the criteria for sepsis and of that number, 29,615 or 46.6% met the criteria for SA-AKI.  Patients with SA-AKI accounted for 15.8% of all ICU admissions.

The study categorized SA-AKI as either concurrent with septic shock or not and occurring early (within 48 hours) or late (2-7 days) of the sepsis diagnosis. Researchers found that 63.9% of SA-AKI patients had the early phenotype, and 26.4% were onset with septic shock within seven days. Late SA-AKI was associated with an increased risk for major adverse kidney events. Also, incident AKI in patients with SA-AKI peaked on the day of sepsis onset and saw a daily decrease over the subsequent week.

In about 50% of cases, patients with both septic shock and SA-AKI experienced major adverse kidney events and showed twice the hospital mortality rate than patients with only one.

“The presence of septic shock significantly worsens outcomes in SA-AKI,” authors of the study wrote. “Updated epidemiology of a common condition, such as SA-AKI, is a critical first step toward identifying vulnerable populations, guiding quality assurance, and informing policy to promote health equity.”

Editor’s note: To read Medscape Medical News’ coverage of this story, click here. To access the Critical Care study, click here.