Clinical Study Of Renal Function Recovery In Sepsis-related Acute Kidney Injury Patients

ObjectiveTo study the renal and clinical prognosis of patients with sepsis-related acute kidney injury,aiming to analyze the related influence factors of renal recovery.MethodsProspectively select Sepsis-Related AKI patients in ICU of Beijing Friendship Hospital affiliated to Capital Medical University from January 2016 to December 2016,their renal function and clinical outcomes were observed at 28 and 90 days.The general condition,early blood routine,laboratory date,APACHA II,SOFA,urine and serum NGAL,TIMP-2,IGFBP-7 and LFABP are analyzed.Totally 49 cases were admitted to the research.The patients were divided into renal function recovery group and renal function non-recovery group according to the outcome of the 90 day.By comparing the two groups,the early predictors of renal function outcome were summarized.Logistic regression and Area under curve(AUC)of receiver operating characteristic(ROC)curve of these factors were used to evaluate the value in predicting prognosis.ResultsTotally 49 cases were admitted to the research,24 of the recovery group,and 25 of the non-recovery group.The recovery rate of renal function is 49% and the most common source of infection is lung infection in ICU.According to the comparison of variables between the two groups,that renal recovery rate will reduce if patients are older,with cardiac insufficiency and hypertension,with higher APACHE-II score,SOFA score excepting kidney and stage of KDIGO standards.Logistic regression analysis model showed that the influence factors of Sepsis-Related AKI patients are mechanical ventilation,APACHE-II score,stage of KDIGO,oliguria,the number of organ failure and hypoproteinemia.APACH-II,SOFA score,blood NGAL,urinary TIMP-2 are related to the AKI recovery.Conclusion1.Age,with cardiac insufficiency and hypertension,number of organ dysfunction,APACH-II score,stage of KDIGO standards,mechanical ventilation,and oliguria are independent risk factors of renal function recovery of Sepsis-Related AKI.APACH-II score or SOFA score excepting kidney can be the predictors of renal function recovery.2.The concentration of blood NGAL and urinary IGFBP-7 has predictive value of renal function recovery.