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Intensive Care Unit versus High-Dependency Care Unit for Patients with Sepsis-Associated Acute Kidney Injury
Yoshihisa Miyamoto1, Hiroyuki Ohbe2,3, Ryota Inokuchi4
1Department of Real-World Evidence, The University of Tokyo, Bunkyo City, Japan, ymiyamoto70@gmail.com; ymiyamoto70-tokyo@umin.ac.jp; ymiyamoto7070@g.ecc.u-tokyo.ac.jp.
Blood Purification
|February 9, 2026
Summary
Patients with sepsis-associated acute kidney injury receiving continuous kidney replacement therapy had similar outcomes whether treated in intensive care units (ICUs) or high-dependency units (HDUs). This suggests staffing levels may not significantly impact sepsis-AKI outcomes with CKRT.
Area of Science:
- Nephrology
- Critical Care Medicine
- Infectious Diseases
Background:
- Sepsis frequently causes severe acute kidney injury (AKI), necessitating continuous kidney replacement therapy (CKRT).
- CKRT is typically administered in intensive care units (ICUs), but high-dependency units (HDUs) offer an alternative with lower staffing intensity.
- The impact of varying medical staffing levels on sepsis-associated AKI outcomes with CKRT remains unclear.
Purpose of the Study:
- To compare the in-hospital mortality and complication rates of patients with sepsis-associated AKI receiving CKRT upon admission to an ICU versus an HDU.
- To investigate the influence of different healthcare settings (ICU vs. HDU) on patient outcomes.
Main Methods:
- Retrospective cohort study utilizing the Diagnosis Procedure Combination database (April 2018-March 2023).
- Inclusion of adult patients with sepsis requiring CKRT initiation upon ICU or HDU admission.
- Propensity score matching weight analyses were employed to compare outcomes between ICU and HDU groups.
Main Results:
- A total of 5,758 patients (1,136 in HDU, 4,622 in ICU) initiated CKRT for sepsis-associated AKI.
- ICU patients exhibited higher SOFA scores, lower BMI, poorer consciousness, and increased mechanical ventilation needs.
- After adjustment, no significant differences in in-hospital mortality or complications (gastrointestinal bleeding, infections, thromboembolism, cerebrovascular events) were observed between ICU and HDU groups.
Conclusions:
- Initial treatment setting (ICU vs. HDU) did not significantly affect in-hospital mortality or clinical outcomes for patients with sepsis-associated AKI receiving CKRT.
- Further research is needed to identify factors guiding patient triage and resource allocation for this population.
Keywords:
Acute kidney injuryContinuous kidney replacement therapyHigh-dependency unitIntensive care unitSepsisMore Related Videos
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