Mortality Rate of Septic and Non-Septic Acute Kidney Injury Patients Requiring Hemodialysis in ICU of Prapokklao Hospital, Chanthaburi
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Abstract
Background: Acute kidney injury is a common clinical problem in critically ill patients and is associated with increased mortality. From previous studies, acute kidney injury is associated with an increased mortality rate, dialysis dependence rate, excess utilization of health resources, and reduced quality of life. Septic acute kidney injury is associated with higher disease severity compared with non-septic acute kidney injury. However, there are sparse data from the Thai population. Our objective is to access mortality rates in septic and non-septic acute kidney injury patients requiring hemodialysis in ICU.
Objective: The aim of this study was to compare the mortality rates of septic and non-septic acute kidney injury patients requiring hemodialysis, indicated by the mortality rate at 7 days and 28 days, lengths of hospital stay, renal recovery, and dialysis dependence. Severity of disease and other predicting factors associated with the mortality rate were also of interest.
Material and methods: This was a retrospective, single-centered, observational study. The medical records of patients with acute kidney injury requiring hemodialysis in ICU from April 2016 to September 2017 were reviewed. A total of 93 patients were included and followed up at 3 months.
Results: There were 93 patients included in this study with mean age 57.7 ± 16.7 years. Males were 62.4%, and 47 patients (50.5%) were in the septic-induced acute kidney injury group while 46 patients (49.5%) were in the non-septic acute kidney injury group. From this study, the septic-induced acute kidney injury patients had a higher mortality rate at 7 days (OR 3.84 p <0.01) and 28 days (OR 4.02 p < 0.01). Septic-induced acute kidney injury patients also had a higher APACHE II score (22.3 ± 5.9 vs. 17.9 ± 6.6 p <0.01). In addition, the APACHE II scores (OR 1.16 and 1.17) and inotropic drug use [OR 17.95 and 8.41) were significantly associated with mortality rates at 7 days and 28 days, respectively. However, lengths of hospital stay, renal recovery, and dialysis dependence rates were not different between septic and non-septic acute kidney injury groups.
Conclusion: Septic-induced acute kidney injury patients requiring hemodialysis in ICU had higher mortality rates at 7 days and 28 days than those with non-septic acute kidney injury. Important poor prognostic factors were APACHE II score and inotropic drug use.
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References
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