Epidemiology and outcomes of early versus late septic acute kidney injury in critically ill patients: A retrospective cohort study

Monard, C; Bianchi, N; Kelevina, T; Altarelli, M; Schneider, A

doi:10.1016/j.accpm.2023.101332

Sepsis & infection

Epidemiology and outcomes of early versus late septic acute kidney injury in critically ill patients: A retrospective cohort study

Anaesth Crit Care Pain MedPublished 1 Dec 2023Retrospective cohort study

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Authors' conclusion

AKI is almost ubiquitous in septic critically ill patients and present within two days of admission. The timing from ICU admission might not be relevant to distinguish different phenotypes of SA-AKI.

Study context

Population: Adults admitted for sepsis to a tertiary ICU, 2010–2020, excluding chronic dialysis or no consent1,660 (90%) with sepsis-associated acute kidney injury (SA-AKI)
Participants: 1,835 adults

Exposure: Early vs late sepsis-associated AKI
Early SA-AKIn = 1,610reference
Late SA-AKIn = 50
Outcome: Relative frequency of early and late SA-AKI (KDIGO criteria)

Methodological detailssingle-centre, tertiary ICU, sensitivity analyses

Single-centre
Tertiary ICU
Sensitivity analyses

Main finding

As reported in the abstract

Frequency of SA-AKI timing among SA-AKI patients

Early SA-AKI97%1610

Late SA-AKI3%50

SA-AKI criteria fulfilled: 1660 (90%)

Observational data: associations, not effects.

Further findings

Early vs late SA-AKI frequency, AKI with elevated sCr only (sensitivity analysis)

Early SA-AKI71%

Late SA-AKI3%

Early vs late SA-AKI frequency, severe AKI only (sensitivity analysis)

Early SA-AKI67%

Late SA-AKI6%

Age · late SA-AKI younger

P < 0.001

Early SA-AKImedian 69 yearsIQR 58–76

Late SA-AKImedian 59 yearsIQR 49–70

Median

Outcome	Early SA-AKI	Late SA-AKI	P value
Charlson comorbidity index	5 (IQR 3–7)	3 (IQR 1–5)	P < 0.001
SAPSII score	53 (IQR 43–64)	41 (IQR 34–50)	P < 0.001
In-hospital mortalitySimilar			P = 0.75

Early vs late SA-AKI frequency, severe AKI only (sensitivity analysis)

Similar proportions with different time windows for early SA-AKI

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Epidemiology and outcomes of early versus late septic acute kidney injury in critically ill patients: A retrospective cohort study. Anaesth Crit Care Pain Med. Published 1 December 2023. doi:10.1016/j.accpm.2023.101332

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