Quantifying the Impact of Alternative Definitions of Sepsis-Associated Acute Kidney Injury on its Incidence and Outcomes: A Systematic Review and Meta-Analysis
Authors' conclusion
SA-AKI is common in ICU patients with sepsis and carries a high risk of death and persisting kidney impairment. The incidence and outcomes of SA-AKI vary significantly depending on the definition of AKI used.
Study context
- Population
- Adults admitted to the ICU with sepsis and/or sepsis-associated acute kidney injury (SA-AKI)
- Participants
- 150,978 adults · 154 studies
- Comparison
- Alternative definitions of SA-AKI
- Outcome
- Proportion of participants in ICU with sepsis who developed AKI
Methodological detailsrandom-effects model, data extracted in duplicate
- Random-effects model
- Data extracted in duplicate
Pooled result
As reported in the abstract
Pooled proportion developing SA-AKI, all definitions
0.40
95% CI 0.37–0.42
Pooled proportion developing SA-AKI, RIFLE, AKIN and KDIGO definitions only
0.52
95% CI 0.48–0.56
Incidence when RRT receipt used to define AKI, lowest
0.26
95% CI 0.24–0.28
Incidence when AKIN score used, highest
0.57
95% CI 0.45–0.69p < 0.01
Further pooled results
Death among patients with SA-AKI · final follow-up
- Proportion died
- 0.48 (95% CI, 0.43-0.53)
- 67 studies, 29,455 participants
Remaining on dialysis among survivors · final follow-up
- Proportion on dialysis
- 0.10 (95% CI, 0.04-0.17)
Original publication
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