Comparison of characteristics and prognosis between septic and non-septic acute kidney injury in Japanese intensive care units

Abstract

The purpose of the research was to compare the characteristics and in-hospital mortality of septic and non-septic acute kidney injury (AKI), using the Japanese Diagnosis Procedure Combination Database in 2011. Adult patients starting acute renal replacement therapy (RRT) in intensive care units were classified into septic AKI and non-septic AKI groups. We compared age, sex, duration between admission and RRT initiation, RRT modality, treatment regimens on the day of RRT initiation, and hospital characteristics, as well as in-hospital mortality of the septic and non-septic AKI groups. Kaplan-Meier survival curves were illustrated. Multivariable logistic regression analysis was performed to estimate odds ratio (septic AKI versus non-septic AKI) for in-hospital mortality. Among 7,353 eligible patients, 2,523 (34.3%) were in the septic AKI group. Patients with septic AKI were slightly older, while the male proportion was smaller. Septic-AKI patients were more likely to receive continuous RRT and severe treatment regimens. In-hospital mortalities were 53.6% (1,353/2,523) and 42.2% (2,038/4,830), in the septic and non-septic AKI groups, respectively (P＜0.001). Adjusted odds ratio for in-hospital mortality was 1.212 (95% confidence interval; 1.086-1.353). In conclusion, patients with septic AKI were more severe and had a higher mortality rate than those with non-septic AKI. In addition, septic AKI was independently associated with increased mortality.