Clinical Features And Risk Factors In Patients With Sepsis-induced Acute Kidney Injury

To analyze the incidence of sepsis-induced acute kidney injury in patients, mortality, clinical features, risk factors and the SOFA score, APACHE Ⅱ scores predict the prognosis of sepsis-induced acute kidney injury role.Methods:March2007to March2012Wuhan Union Hospital ICU admitted141patients with sepsis, medical records, and statistics related to personal and clinical information were studied retrospectively. To whether the occurrence of acute kidney injury (AKI, Acute Kidney Injury) divided into the AKI groups and non-AKI group. Compare differences between the two groups of indicators, calculated SOFA score and APACHE Ⅱ score, Logistic regression analysis to find the possible risk factors for sepsis and acute renal injury. Two receiver operating characteristic (ROC) curve score predict its prognosis.Results:141cases of sepsis patients developed AKI patients in70cases, sepsis-induced acute kidney injury incidence rate of49.65%. Patient’s death in48cases, the mortality rate to34.04%, the AKI group killed30people, the mortality rate was42.86%, the non-AKI group,18people died, the mortality rate to25.35%, the AKI group of higher mortality than non-AKI group, the difference was statistically significance (χ2=4.81, P=0.028). AKI group and non-AKI group, age, combined chronic diseases, mean arterial pressure, coagulation, arterial pH, Lac value, breathing machine utilization and application time, the statistical difference in the bacterial culture positive rate (P<0.05). Logistic regression analysis showed that single factor:age, arterial pH, SOFA score, a statistically significant difference (P<0.05), Multivariate Logistic regression analysis showed:age, arterial pH, SOFA score, sepsis-induced acute kidney injury risk factors (P<0.05). The SOFA score AUC to0.768, and the AUC was0.891APACHE Ⅱ scoring system, the difference was statistically significant (Z=35.678, P<0.01).Conclusion:The patients with sepsis easy to induce the onset of acute kidney injury and poor prognosis; senior citizens, arterial blood PH value decreased, SOFA score increased risk factors for sepsis and acute kidney injury; SOFA score and APACHE Ⅱ score can predict the prognosis of sepsis-induced acute kidney injury, but the predictive ability of APACHE Ⅱ score on prognosis better than the SOFA score.