Outcome of sepsis-associated acute kidney injury in an intensive care unit: an experience from a tertiary care center of central Nepal

Saudi J Kidney Dis Transpl. 2014 Jul;25(4):912-7. doi: 10.4103/1319-2442.135229.

Abstract

Acute kidney injury (AKI) is a common and major complication of sepsis. Sepsis-induced AKI is associated with higher morbidity and mortality. A prospective study was designed to include all the patients with a provisional diagnosis of sepsis with AKI admitted in our intensive care unit from August 2009 to September 2010. Detailed demographic data including various clinical parameters, co-morbidities, investigations, complications and outcome were entered in a designated proforman and were analyzed. A total of 53 subjects with the provisional diagnosis of sepsis with AKI were included in the study. The majority of patients (60.37%) were female. The mean age of the study population was 45.84 ± 20.5 years. Forty-nine percent of the subjects were <45 years old and 26.4% patients were >65 years. Among the co-morbid conditions, 9.4% subjects had diabetes mellitus type 2. Among the primary causes of AKI, 72% of the cases were due to medical causes, in which pneumonia was the major cause, and 28% were due to surgical causes, in which cholecystitis was the major cause. 47.1% cases expired, 11.3% subjects left against medical advice and 41.5% cases had favorable outcome. Among the expired cases, 20.7% subjects expired within 24 h; for others, the median hospital stay was four days. This prospective study showed that the major causes of AKI were medical illness and pneumonia. Mortality in sepsis-induced AKI is significantly high. This highlights the importance of prevention of AKI in sepsis by early and renal-friendly aggressive treatment of sepsis and the need for improvement in the management of such AKI cases.

Publication types

  • Observational Study

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / mortality
  • Acute Kidney Injury / therapy*
  • Adult
  • Aged
  • Cause of Death
  • Comorbidity
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units*
  • Length of Stay
  • Male
  • Middle Aged
  • Nepal
  • Prospective Studies
  • Risk Factors
  • Sepsis / complications
  • Sepsis / diagnosis
  • Sepsis / mortality
  • Sepsis / therapy*
  • Tertiary Care Centers*
  • Time Factors
  • Treatment Outcome