- Acute Kidney Injury often times accompanies sepsis.
- Sepsis Associated Acute Kidney Injury (SA-AKI) has a greater morbidity and mortality rate than sepsis or acute kidney injury alone.
- The outcome of SA-AKI has not been extensively reported due to differences in reproducibility and standard consensus definition.
- SA-AKI can be categorized? by stage or definition of AKI.
- Typically SA-AKI is based on the presence of the following components and definitions:
- White KC, et al. Sepsis associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. A multicenter, observational study. Intensive Care Med 2023;49:1079-1089.
- 84,528 patients admitted to ICU in 12 ICU’s from Australia
- January 1, 2015 – December 31, 2021
- 13,451 sepsis patients, with most meeting sepsis and AKI definitions on day 1 to ICU
- Incidence of SA-AKI increased each year, with a higher severity of illness compared to non-sepsis ICU patients
- AKI diagnosis Criteria:
- -- Urine Output Only: 5,952 (44.3%) patients
- -- Creatinine Only: 4,642 (34.5%) patients
- -- Both: 2,857 (21.2%) patients
- A statistically significant difference occurs in all outcome categories between AKI categories of urine output alone; creatinine alone; or both
- Using urine output alone has the clinical marker has the best outcomes, however, may be a misleading predictive indicator.
- Using both urine output and creatinine markers may provide a better predictor of eventual outcomes.
- The incidence of SA-AKI has increased annually from 2015 to 2021.
- SA-AKI has a higher severity of illness and a poorer outcome than sepsis alone or AKI alone.
- SA-AKI diagnosed via a low urine output alone has a shorter ICU and hospital LOS; lower mortality and less 30 day adverse event development.
- It is unknown if a low urine output? is a physiologic response to sepsis or a marker of impending organ failure.
Erkan Hassan, Pharm.D., FCCM is a transformational healthcare leader with extensive experience developing innovative solutions to improve clinical outcomes, enhance provider experience and increase revenue.
You can reach Erkan at [email protected]
