Sepsis-Associated Acute Kidney Injury and 28-Day Mortality in Critically Ill Patients with Sepsis: A Retrospective Cohort Study
Journal of Clinical Medicine, cilt.15, sa.16, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 15 Sayı: 16
- Basım Tarihi: 2026
- Doi Numarası: 10.3390/jcm15166171
- Dergi Adı: Journal of Clinical Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, Academic Search Ultimate (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: intensive care unit, mortality, sepsis, sepsis-associated acute kidney injury
- Bursa Uludağ Üniversitesi Adresli: Evet
Özet
Background/Objectives: We aimed to analyse the development of acute kidney injury (AKI), its association with mortality, and mortality-associated factors in patients admitted to the intensive care unit (ICU) with sepsis. Methods: This retrospective cohort study was conducted on adult patients with sepsis admitted to the ICU of a tertiary-care hospital between January 2023 and December 2023. Demographic, clinical, and laboratory data within the first 24 h of admission to the ICU were recorded. These data were compared between patients with and without sepsis-associated acute kidney injury (SA-AKI). Results: Among 1163 admissions, 185 met the study criteria, and the incidence of SA-AKI was 45.4%. The overall 28-day mortality was 38.4%. Patients with SA-AKI had significantly higher mortality than those without SA-AKI (63.1% vs. 17.8%, p < 0.001). In the multivariable Cox regression analysis, SA-AKI was independently associated with a higher risk of 28-day mortality (HR = 2.87, 95% CI 1.51–5.45, p = 0.001). Among patients with SA-AKI, elevated lactate showed a borderline association with mortality (HR = 1.06 per mmol/L, 95% CI 1.00–1.13, p = 0.053); first-day vasopressor use was not independently associated with mortality after adjustment for illness severity. Conclusions: SA-AKI was independently associated with higher 28-day mortality. Within the SA-AKI subgroup, lactate showed only a borderline association with mortality, whereas first-day vasopressor use appeared to reflect illness severity.