Evaluation of acute kidney injury patients in intensive care unit and determining effects of hemodialysis on sepsis

Abstract

Aim: Sepsis-associated acute kidney injury (AKI) is a frequent complication of critically ill patients, and results need for renal replacement therapy (RRT). We aimed to investigate the difference in vital signs, hemodynamic parameters, and laboratory values after receiving RRT in the AKI patients with/without sepsis. Also, we examined the different renal injury grading systems relationships used in intensive care units (ICU). Methods: RRT-treated patients due to AKI were enrolled. Patients were divided into two groups by using Sepsis-2 criteria (2012); whether there is sepsis or not. Acute physiology and chronic health evaluation II (APACHE  II) scores, 28th and 90th day mortality recorded. RIFLE classes, renal sequential organ failure assessment (SOFA) scores, and kidney disease: improving global outcomes (KDIGO), stages were also calculated. Patients’ Glasgow Coma Scale (GCS), vital parameters, laboratory values, Horowitz rates, vasopressor/inotropic agent requirements at RRT start, 12th and 24th hours were recorded. Results: 153 patients were included in the study, and 93 were septic. APACHE II score and 28th day mortality were significantly higher in Group Sepsis. Advanced age was found to be associated with 90th day mortality. Both in two groups many parameters such as acidosis, Horowitz ratio, and GCS improved after RRT initiation. When renal scoring systems were compared with each other KDIGO was associated with the RIFLE classification and renal SOFA. Conclusion: Many improvements were observed in all AKI patients after RRT but in septic patients, oxygenation and GCS showed better improvement. The mortality rate increased when AKI got complicated with sepsis.