Abstract
BackgroundSepsis is known to cause renal function fluctuations during hospitalization, but whether these patients discharged from sepsis were still at greater risks of long-term renal adverse outcomes remains unknown.MethodsFrom 2011 to 2018, we included 1,12,628 patients with chronic kidney disease (CKD) aged ≥ 20 years. The patients with CKD were further divided into 11,661 sepsis group and 1,00,967 non-sepsis group. The following outcome of interest was included: all-cause mortality, readmission for acute kidney injury, estimated glomerular filtration rate decline ≥50% or doubling of serum creatinine, and end-stage renal disease.ResultsAfter propensity score matching, the sepsis group was at higher risks of all-cause mortality [hazard ratio (HR) 1.39, 95% CI, 1.31–1.47], readmission for acute kidney injury (HR 1.67, 95% CI 1.58–1.76), eGFR decline ≥ 50% or doubling of serum creatinine (HR 3.34, 95% CI 2.78–4.01), and end-stage renal disease (HR 1.43, 95% CI 1.34–1.53) than non-sepsis group.ConclusionsOur study found that patients with CKD discharged from hospitalization for sepsis have higher risks of subsequent renal adverse events.
Highlights
Chronic kidney disease (CKD) is a global health burden with a prevalence of ∼10–16% worldwide and a high economic cost [1,2,3]
After propensity score matching, the sepsis group was at higher risks of allcause mortality [hazard ratio (HR) 1.39, 95% CI, 1.31–1.47], readmission for acute kidney injury (HR 1.67, 95% CI 1.58–1.76), estimated glomerular filtration rate (eGFR) decline ≥ 50% or doubling of serum creatinine (HR 3.34, 95% CI 2.78–4.01), and end-stage renal disease (HR 1.43, 95% CI 1.34–1.53) than non-sepsis group
Our study found that patients with CKD discharged from hospitalization for sepsis have higher risks of subsequent renal adverse events
Summary
Chronic kidney disease (CKD) is a global health burden with a prevalence of ∼10–16% worldwide and a high economic cost [1,2,3]. Sepsis and Renal Outcomes in CKD Patients. Sepsis-inducing inflammatory cytokines have been shown to be associated with the severity and worsening of renal function impairment [14, 15]. Plasma extracted from patients with septic still induced renal cell injury and renal tubular and podocyte apoptosis without the presence of vasculature or circulating inflammatory cells [16]. There is increasing evidence that sepsis can increase the risk of acute kidney injury (AKI) [17,18,19], the relationship between sepsis and long-term renal adverse outcomes, especially in the fragile population with CKD, remains unclear. Sepsis is known to cause renal function fluctuations during hospitalization, but whether these patients discharged from sepsis were still at greater risks of long-term renal adverse outcomes remains unknown
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