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Impact of severe acute kidney injury on short-term mortality in urosepsis
Naoki Fujita1, Masaki Momota2,3, Osamu Soma2,3
1Department of Urology, Hirosaki University Graduate School of Medicine, 5-Zaifucho, Hirosaki, 036-8562, Japan. naonao707012@hirosaki-u.ac.jp.
Purpose:
To evaluate the impact of severe acute kidney injury (AKI) on short-term mortality in patients with urosepsis.
Methods:
This prospective cohort study evaluated 207 patients with urosepsis. AKI was diagnosed in accordance with the Kidney Disease Improving Global Outcomes criteria, and severe AKI was defined as stage 2 or 3 AKI. Patients were divided into two groups: patients who developed severe AKI (severe AKI group) and patients who did not (control group). The primary endpoint was all-cause mortality within 30 days. The secondary endpoints were 90-day mortality and in-hospital mortality. The exploratory outcomes were the risk factors for severe AKI development.
Results:
The median patient age was 79 years. Of the 207 patients, 56 (27%) developed severe AKI. The 30-day mortality rate in the severe AKI group was significantly higher than that in the control group (20% vs. 2.0%, respectively; P < 0.001). In the multivariable analysis, performance status and severe AKI were significantly associated with 30-day mortality. The in-hospital mortality and 90-day mortality rates in the severe AKI group were significantly higher than those in the control group (P < 0.001 and P < 0.001, respectively). In the multivariable analysis, age, urolithiasis-related sepsis, lactate values, and disseminated intravascular coagulation were significantly associated with severe AKI development.
Conclusions:
Severe AKI was a common complication in patients with urosepsis and contributed to high short-term mortality rates.
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