Despite the clinical importance of sepsis-associated acute kidney injury (SA-AKI), little is known about its epidemiology. We aimed to investigate the incidence and outcomes of SA-AKI, as well as the risk factors for mortality among patients with severe SA-AKI in critically ill patients. This secondary multicenter, observational, prospective cohort analysis of sepsis in South Korea evaluated patients aged ≥ 19 years admitted to intensive care units with a diagnosis of sepsis. The primary outcome was the incidence of SA-AKI, defined using the new consensus definition of the Acute Disease Quality Initiative 28 Workgroup. Secondary outcomes were in-hospital mortality and risk factors for in-hospital mortality. Between September 2019 and December 2022, 5100 patients were admitted to intensive care units with a diagnosis of sepsis, and 3177 (62.3%) developed SA-AKI. A total of 613 (19.3%), 721 (22.7%), and 1843 (58.0%) patients had stage 1, 2, and 3 SA-AKI, respectively. Severe SA-AKI (stages 2 and 3 combined) was associated with an increased risk of in-hospital mortality. Adherence to the fluid resuscitation component of the one-hour sepsis bundle was associated with a decreased risk of in-hospital mortality in severe SA-AKI (adjusted odds ratio, 0.62; 95% confidence interval, 0.48–0.79; P < 0.001). Of the patients admitted to the intensive care unit for sepsis, 62.3% developed SA-AKI. Severe SA-AKI was associated with an increased risk of mortality. Adherence to the fluid resuscitation component of the one-hour sepsis bundle can potentially improve outcomes in these patients.

中文翻译：

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危重患者脓毒症相关急性肾损伤的流行病学：韩国的一项多中心、前瞻性、观察性队列研究


尽管脓毒症相关急性肾损伤 （SA-AKI） 具有临床重要性，但对其流行病学知之甚少。我们旨在调查危重症 SA-AKI 患者的发病率和结局，以及死亡的危险因素。这项针对韩国脓毒症的二级多中心、观察性、前瞻性队列分析评估了被诊断为脓毒症的重症监护病房收治的 ≥ 岁 19 岁的患者。主要结局是 SA-AKI 的发生率，使用急性疾病质量倡议 28 工作组的新共识定义定义。次要结局是院内死亡率和院内死亡率的危险因素。2019 年 9 月至 2022 年 12 月期间，5100 名诊断为脓毒症的患者入住重症监护病房，其中 3177 名 （62.3%） 患者发展为 SA-AKI。共有 613 名 （19.3%） 、 721 名 （22.7%） 和 1843 名 （58.0%） 患者分别患有 1 期、 2 期和 3 期 SA-AKI。严重的 SA-AKI （2 期和 3 期结合） 与院内死亡风险增加相关。对 1 小时脓毒症集束化液复苏成分的依从性与严重 SA-AKI 的院内死亡风险降低相关（校正比值比，0.62;95% 置信区间，0.48-0.79;P < 0.001）。在因脓毒症入住重症监护病房的患者中，62.3% 发生 SA-AKI。严重的 SA-AKI 与死亡风险增加相关。依从一小时脓毒症集束化治疗的液体复苏部分可能会改善这些患者的预后。