Clinical study of renal function recovery in sepsis-related acute kidney injury patients

doi:10.3969/j.issn.1006-7795.2018.01.005

Abstract

Abstract: Objective To study the renal and clinical prognosis of patients with sepsis-related acute kidney injury (AKI), aiming to analyze the related influencing factors of renal recovery.Methods Sepsis-related AKI patients were prospectively selected in intensive care unite (ICU) of Beijing Friendship Hospital, Capital Medical University from January 2016 to December 2016, their renal function and clinical outcomes were observed at 28 and 90 days. The patients were divided into renal function recovery group and renal function non-recovery group according to the outcome of the 90 day. By comparing the two groups, the early predictors of renal function outcome were summarized. Logistic regression and area under curve (AUC) of receiver operating characteristic(ROC) curve of these factors were used to evaluate the value in predicting prognosis.Results Totally 49 cases were enrolled into the research, 24 of the recovery group, and 25 of the non-recovery group. The recovery rate of renal function was 49% and the most common source of infection is lung infection in ICU. According to the comparison of variables between the two groups, that renal recovery rate is infected with age, cardiac insufficiency and hypertension, Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score, Sepsis-related Organ Failure Assessment (SOFA) Score excepting kidney, stage of Kidney Disease Improving Global Outcomes (KDIGO), numbers of organ failure, number of platelets, blood lactate, pneumonia, respiratory failure, oliguria, mechanical ventilation, vasoactive drugs and urinary tissue inhibitor of metalloproteinase-2 (TIMP-2), blood neutrophil gelatinase-associated lipocalin (NGAL), blood liver fatly acid binding protein (LFABP) of patients into the research immediately. Logistic regression analysis model showed that the influence factors of sepsis-related AKI patients are mechanical ventilation, APACHEⅡ score, stage of KDIGO, oliguria, hypoproteinemia, blood NGAL, urinary TIMP-2. APACHEⅡ, SOFA score excepting kidney, blood NGAL, urinary TIMP-2 are related to the AKI recovery.Conclusion APACHEⅡ score and SOFA score excepting kidney,blood NGAL and urinary TIME-2 after sepsis diagnosed immediately have predictive value of renal function recovery.

Key words: sepsis, acute kidney injury, renal recovery

CLC Number:

R692

Yu Shujing, Liu Pei, Lin Jin, Liu Jingfeng, Ji Xiaojun, Liu Zhuang, Dong Lei, Duan Meili. Clinical study of renal function recovery in sepsis-related acute kidney injury patients[J]. Journal of Capital Medical University, 2018, 39(1): 21-27.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2018.01.005

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2018/V39/I1/21

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