Abstract: FR-PO127

Factors Associated with Dialysis-Requiring AKI in Patients with Septic Shock

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Pan, Di, Mount Sinai St. Lukes and Mount Sinai West Hospitals, New York, New York, United States
  • Mariuma, David, Mount Sinai St. Lukes and Mount Sinai West Hospitals, New York, New York, United States
  • Wen, Yumeng, Mount Sinai St. Lukes and Mount Sinai West Hospitals, New York, New York, United States
  • Vazquez de lara, Fernando, Mount Sinai St. Lukes and Mount Sinai West Hospitals, New York, New York, United States
  • Hernandez cuchillas, Marcelo Xavier, Mount Sinai St. Lukes and Mount Sinai West Hospitals, New York, New York, United States
  • Gramuglia, Michael, Montefiore Health System, New York, New York, United States
  • Meisels, Ira S., Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, New York, United States
Background

Acute kidney injury (AKI) poses significant burden on patients with septic shock, especially for those who ultimately require renal replacement therapy (RRT). The aim of this study is to identify potential risk factors and patient characteristics associated with receiving RRT in patients with septic shock.

Methods

This is a retrospective analysis based on the 2014 Nationwide Inpatient Sample. A total of 435,835 patients over age 18 with either a primary or secondary diagnosis of septic shock were included. Patients on chronic RRT were excluded. The outcome of interest was dialysis-requiring AKI. Multivariate logistic regression adjusting for age, gender, hospital characteristics, insurance, and comorbidities was performed to test for independent associations between variables of interest (which included 29 AHRQ comorbidity measures), and dialysis-requiring AKI. Diagnoses and procedures were identified using ICD-9-CM codes. Analysis was performed using STATA 14.2.

Results

Our study revealed that male gender (OR 1.24, p<0.0001), African-American (OR 1.34, p<0.0001), and Hispanic (OR 1.14, p=0.03) race have increased odds of having AKI-requiring dialysis in septic shock. Pre-existing comorbidities and other factors found to have increased association with AKI-requiring dialysis were: chronic alcohol abuse (OR 1.20, P=0.005), chronic anemia (OR 1.16, p<0.0001), congestive heart failure (OR 1.13, p=0.001), coagulopathy (OR 2.07, p<0.0001), diabetes with complications (1.27, p<0.0001), history of hypertension (OR 1.14, P<0.0001), chronic liver disease (OR 1.45, p<0.0001), obesity (OR 1.67, p<0.0001), pulmonary circulation disorders (OR 1.21, p=0.001), and the presence of bacteremia (OR 1.97, p=0.005).

Conclusion

Clinical and microbiological characteristics, as well as pre-existing comorbidities should be considered in the prognostication and risk stratification of patients with septic shock, and the development of dialysis-requiring AKI. Future prospective studies can be considered for further evaluation.