SEPSIS AS A MORTALITY INDICATOR IN ACUTE KIDNEY INJURY PATIENTS IN ICU

Dr . V. R. Aditya Chainulu, Dr. V. Padma, Dr. Indhuja

Abstract


Sepsis is an extreme and dysregulated inflammatory response to infection that is distant from the primary site of infection resulting in end-organ damage. Appearance of acute kidney injury (AKI) during sepsis raises patient morbidity, predicts higher death rates, has a significant effect on functions of multiple organs, is associated with a prolonged duration of stay in the intensive care unit, and hence warrants appropriate healthcare resources. Pathophysiology, diagnostic procedures and appropriate therapeutic interventions in sepsis are still highly debatable despite impressive advances in several medical fields. The overwhelmingly high mortality rate of sepsis is not reduced despite multiple immunomodulatory agents showing promise in preclinical studies. Major obstacles to progress in understanding, early diagnosis, and implementing effective therapeutic modalities in sepsis-induced AKI comprise minimal histopathological data, few animal models closely emulating human sepsis, and a relative lack of specialized diagnostic tools. Here we analyse 100 ICU patients who developed AKI and sepsis as a major etiological factor as well as mortality indicator.


Keywords


Sepsis, Acute Kidney Injury, Mortality, Intensive Care Unit, etiology.

Full Text:

PDF

References


Mehta RL, Pascual MT, Soroko S, Savage BR, Himmelfarb J, Ikizler TA, Paganini EP, Chertow GM, Program to Improve Care in Acute Renal Disease (PICARD. Spectrum of acute renal failure in the intensive care unit: the PICARD experience. Kidney international. 2004 Oct 1;66(4):1613-21.

Palevsky PM. Epidemiology of acute renal failure: the tip of the iceberg.

Ympa YP, Sakr Y, Reinhart K, Vincent JL. Has mortality from acute renal fai lure decreased? A systematic review of the literature. The American journal of medicine. 2005 Aug 1;118(8):827-32.

Metnitz PG, Krenn CG, Steltzer H, Lang T, Ploder J, Lenz K, Le Gall JR, Druml W. Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients. Critical care medicine. 2002 Sep 1;30(9):2051-8.

Waikar SS, Curhan GC, Wald R, McCarthy EP, Chertow GM. Declining mortality in patients with acute renal failure, 1988 to 2002. Journal of the American Society of Nephrology. 2006 Apr 1;17(4):1143-50.

Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C,Macedo E, Gibney N. Acute renal failure in critically ill patients: a multinational, multicenter study. Jama. 2005 Aug 17;294(7):813-8.

Liangos O, Wald R, O’Bell JW, Price L, Pereira BJ, Jaber BL. Epidemiology and outcomes of acute renal failure in hospitalized patients: a national survey Clinical journal of the American Society of Nephrology. 2006 Jan 1;1(1):43-51.

Clermont G, Acker CG, Angus DC, Sirio CA, Pinsky MR, Johnson JP. Renal failure in the ICU: comparison of the impact of acute renal failure and end-stage renal disease on ICU outcomes. Kidney international. 2002 Sep 1;62(3):986-96.

Thakar CV, Worley S, Arrigain S, Yared JP, Paganini EP. Influence of renal dysfunction on mortality after cardiac surgery: modifying effect of preoperative renal function. Kidney international. 2005 Mar 1;67(3):1112-9.

Druml W. Long term prognosis of patients with acute renal failure: is intensive care worth it?.

Liano F, Junco E, Madero R, Pascual J, Verde E. The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. Kidney International -Supplements. 1998 May 1(66):16-24.

Mehta RL, Pascual MT, Soroko S, Chertow GM, PICARD Study Group. Diuretics, mortality, and nonrecovery of renal function in acute renal failure. Jama. 2002 Nov 27;288(20):2547-53.

Chertow GM, Burdick E, Honour M, Bonventre V, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. Journal of the American Society of Nephrology. 2005 Nov1;16(11):3365-70.

Gruberg L, Mintz GS, Mehran R, Dangas G, Lansky AJ, Kent KM, Pichard AD, Satler LF, Leon MB. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. Journal of the American College of Cardiology. 2000 Nov 1;36(5):1542-8.

Lassnigg A, Schmidlin D, Mouhieddine M, Bachmann LM, Druml W, Bauer P, Hiesmayr M. Minimal changes of serum creatinine predict prognosis in patients after cardiothoracic surgery: a prospective cohort study. Journal of the American Society of Nephrology. 2004 Jun 1;15(6):1597-605.

Qutub HO, Saeed IA. Acute renal failure in intensive care unit. Saudi Med J 2001;22:999-1003.

Agarwal I, Kirubakaran C, Markandeyulu V. Clinical profile and outcome of acute renal failure in South Indian children. Journal of the Indian Medical Association. 2004 Jul;102(7):353-4.

Macedo E, Malhotra R, Bouchard J, Wynn SK, Mehta RL. Oliguria is an early predictor of higher mortality in critically ill patients. Kidney international. 2011 Oct 1;80(7):760-7.


Refbacks

  • There are currently no refbacks.