Volume 19 Supplement 1

35th International Symposium on Intensive Care and Emergency Medicine

Open Access

Risk factors for acute kidney injury in patients with complicated intra-abdominal infection

  • A Suarez de la Rica1,
  • E Maseda1,
  • V Anillo1,
  • C Hernandez-Gancedo1,
  • A Lopez-Tofiño1,
  • M Villagran1 and
  • F Gilsanz1
Critical Care201519(Suppl 1):P284

https://doi.org/10.1186/cc14364

Published: 16 March 2015

Introduction

AKI has been poorly studied in surgical septic patients. The aim of our study was to determine the factors related to AKI in surgical septic patients with complicated intra-abdominal infection (CIAI) and mortality associated with AKI in this setting.

Methods

An observational study was performed of all adult patients with CIAI requiring surgery and ICU admission from June 2011 to June 2013. We recorded demographic data, SAPS II, SOFA score at admission, presence of septic shock, history of pre-existing comorbidities, angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), NSAIDs, statins or diuretics consumption, baseline creatinine and at admission, and standard biomarkers. Factors associated with developing AKI and renal replacement therapy (RRT) were studied using a multivariate analysis. Association between mortality and AKI and RRT need was also analyzed.

Results

A total of 114 patients were included, with a mean SAPS II of 42.14. Sixty-seven patients (58.8%) developed AKI and 33 (28.9%) required RRT. Development of AKI (R2 = 0.498; P < 0.0001; AUC = 0.926) was independently associated with SOFA (OR = 1.57; 95% CI = 1.29, 2.02) and creatinine at admission (OR for 0.1 units = 1.56; 95% CI = 1.30, 1.99). RRT need (R2 = 0.382; P < 0.0001; AUC = 0.892) was independently associated with arterial hypertension (HTN) (OR = 4.90; 95% CI = 1.50, 15.97) and SOFA score (OR = 1.71). In another model with more predictive capacity (R2 = 0.433; P < 0.0001; AUC = 0.918) the number of previous medications (OR = 3.73; 95% CI = 1.92, 8.38) and SOFA score (OR = 1.86; 95% CI = 1.47, 2.54) were related to RRT need. Both AKI and RRT need were related to ICU (RR = 8.41, 95% CI = 1.14, 62.5; and RR = 8, 95% CI = 2.40, 27.85 respectively) and 28-day mortality (RR = 2.8, 95% CI = 1.00, 7.86; and RR = 4.65, 95% CI =1.99, 10.40 respectively).

Conclusion

Severe AKI with RRT need is highly associated with previous HTN. The number of previous medications is related to severe AKI too. HTN has been described as a risk factor for developing AKI in critically ill patients [1]. ACEI and ARB use has been associated with AKI development in septic patients [2]. To our knowledge, this is the first study that investigates risk factors associated with AKI in surgical septic patients with CIAI.

Authors’ Affiliations

(1)
Hospital Universitario La Paz

References

  1. Cartin Ceba R, et al: Risk factors for development of acute kidney injury in critically ill patients: a systematic review and meta-analysis of observational studies. Crit Care Res Pract. 2012, 691013-Google Scholar
  2. Suh SH, et al: Acute kidney injury in patients with sepsis and septic shock: risk factors and clinical outcomes. Yonsei Med J. 2013, 965-72. 54PubMed CentralView ArticlePubMedGoogle Scholar

Copyright

© Suarez de la Rica et al.; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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