Hydrocortisone and Risk Factors for Kidney Replacement Therapy in Septic Shock
Authors' conclusion
In this post hoc cohort study of patients with septic shock enrolled in a large RCT, intravenous hydrocortisone was associated with a reduced risk of new KRT requirement following randomization.
Study context
- Population
- Patients with septic shock enrolled in ADRENAL (69 ICUs in Australia, UK, New Zealand, Saudi Arabia, Denmark; 2013–2017) without kidney replacement therapy (KRT) in 24 h before randomisation or prior longstanding dialysis
- Participants
- 3,161 patients
- Comparison
- Hydrocortisone vs placebo
- Hydrocortisonen = 1,589
- Placebon = 1,572reference
- Primary endpoint
- KRT requirement and liberation from KRT (days alive and free of KRT)
Methodological detailspost hoc analysis, cohort study, multicentre, placebo-controlled
- Post hoc analysis
- Cohort study
- Multicentre
- Placebo-controlled
Primary result
As reported in the abstract
KRT requirement
Hydrocortisone vs PlaceboOdds ratio (95% CI)P value
KRT requirement
0.84(0.70–0.99)
P = 0.04Controlled for factors associated with KRT requirement
0.79(0.66–0.95)
P = 0.01Further findings
| Outcome | Mean difference (days) (95% CI) | P value | |
|---|---|---|---|
| Days alive and free of KRT (patients who started KRT after randomisation) | 1.28 (−4.31 to 6.87) | P = 0.65 | |
| −50510Difference, days (linear scale) |
Original publication
Hydrocortisone and Risk Factors for Kidney Replacement Therapy in Septic Shock. JAMA Netw Open. Published 1 May 2025. doi:10.
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