Kidney Week

Abstract: TH-OR015

Epidemiology of Sepsis-Associated AKI in Critically Ill Adolescents

Session Information

• AKI Across the Care Continuum: From Detection to Recovery
  October 22, 2026 | Location: Room 203, Convention Center
  Abstract Time: 05:20 PM - 05:30 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Odum, James D., The University of Alabama at Birmingham, Birmingham, Alabama, United States

James D. Odum, MD, MEd

• Hirata, Kaiho, The University of Alabama at Birmingham, Birmingham, Alabama, United States

Kaiho Hirata, MD

• Braun, Chloe Grace, University of Louisville School of Medicine, Louisville, Kentucky, United States

Chloe Grace Braun, MD

• Takeuchi, Tomonori, The University of New Mexico School of Medicine, Albuquerque, New Mexico, United States

Tomonori Takeuchi, MD

• Barbera, Andrew Jason, The University of Alabama at Birmingham, Birmingham, Alabama, United States

Andrew Jason Barbera, MD

• Carter, Stuart M., The University of Alabama at Birmingham, Birmingham, Alabama, United States

Stuart M. Carter, MS

• Pranto, Shehan Irteza, The University of Alabama at Birmingham, Birmingham, Alabama, United States

Shehan Irteza Pranto, MS

• Shampa, Sadia Yesmin, The University of Alabama at Birmingham, Birmingham, Alabama, United States

Sadia Yesmin Shampa

• Askenazi, David J., The University of Alabama at Birmingham, Birmingham, Alabama, United States

David J. Askenazi, MD, MS, FASN

• Neyra, Javier A., The University of Alabama at Birmingham, Birmingham, Alabama, United States

Javier A. Neyra, MD, MS, FASN

Background

Adolescents are a unique population undergoing developmental transition from pediatric to adult physiology and who are treated at both pediatric and adult intensive care units (ICUs) during critical illness. The epidemiology of SA-AKI among adolescents in adult ICU settings remain poorly defined.

Methods

This single-center cohort study included patients aged 10 to 39 years admitted to any ICU at a tertiary adult academic institution with sepsis between January 2012 and December 2023. Adolescents were defined as aged 10 to 17 years; patients aged 18 to 25 years and 26 to 39 years served as comparison groups. The primary outcome was major adverse kidney events, defined as a composite of death, renal replacement therapy dependence, or persistent kidney dysfunction (serum creatinine ≥1.5 times or eGFR≤50% of baseline) at hospital discharge (MAKE-discharge).

Results

Among 7,320 patients with sepsis, the incidence of MAKE-discharge was similar across age groups (35.1% for ages 10–17 years, 31.8% for ages 18–25 years, and 33.1% for ages 26–39 years; p = 0.41). Adolescents had higher rates of septic shock and invasive mechanical ventilation but lower rates of Nephrology consultation (1.6% vs 4.3% vs 6.3%; p < 0.001). In multivariable analysis, patients aged 18 to 25 years (odds ratio [OR], 0.67; 95% CI, 0.51–0.89) and 26 to 39 years (OR, 0.66; 95% CI, 0.50–0.87) had lower odds of MAKE-discharge compared with adolescents.

Conclusion

Adolescents with sepsis treated in adult ICUs experienced worse kidney-related outcomes and lower rates of Nephrology consultation compared with young adults. These findings may reflect differences in care delivery or underlying disease severity, highlighting a vulnerable patient population within adult ICU systems.

Multivariable logistic regression analysis of major adverse kidney events at hospital discharge

Funding

• NIDDK Support