Early prognosis of patients with sepsis-related acute kidney injury receiving continuous renal replacement therapy in the intensive care unit

Objectives The aim of this study was to determine the clinical characteristics of patients with sepsis-induced acute kidney injury (SI-AKI) requiring continuous renal replacement therapy (CRRT) and their risk factors for mortality. Methods This was a single-centre, retrospective, observational study that included 108 patients who underwent CRRT between 1 January 2022 and 31 December 2022 in the intensive care unit (ICU) of The Affiliated Wuxi People' s Hospital of Nanjing Medical University. The patients were divided into the SI-AKI group and the Non-SI-AKI group, and the 30-day prognosis of the two groups was investigated using the Kaplan-Meier survival curve, and the associated risk factors for death were investigated using multifactorial COX regression analysis. Results Compared with the non-SI-AKI group, SI-AKI patients were older [72 (60, 78) vs. 60 (51, 70) years, P = 0.003], with higher SOFA score [9.0 (7.0, 10.0) vs. 6.0 (5.0, 7.0), P < 0.001] and APACHE II score [12.0 (10.0, 16.0) vs. 8.0 (7.0, 10.0), P < 0.001] were higher. During CRRT, patients with SI-AKI required mechanical ventilation for a longer period of time [11 (4, 23) days vs. 4 (1, 9) days, P < 0.001] and had a higher rate of extubation failure [21 (35.59%) vs. 7 (14.29%), P = 0.012]. In addition, patients with SI-AKI had worse 30-day outcomes and had lactate levels [HR 1.133, 95%CI 0.908, 1.415, P = 0.009] and extubation failures [HR 1.014, 95%CI 1.002, 1.090, P < 0.001] as risk factors for developing 30-day mortality. Conclusions The early prognosis of SI-AKI patients treated with CRRT does not appear to be favorable, which may be related to the severity of the patient's disease. Lactate levels and the occurrence of failed extubation can increase the risk of 30-day mortality.