Risk Factors for Mortality in Patients with Septic Acute Kidney Injury in Intensive Care Units in Beijing, China: A Multicenter Prospective Observational Study

OBJECTIVE To discover risk factors for mortality of patients with septic AKI in ICU via a multicenter study. BACKGROUND Septic AKI is a serious threat to patients in ICU, but there are a few clinical studies focusing on this. METHODS This was a prospective, observational, and multicenter study conducted in 30 ICUs of 28 major hospitals in Beijing. 3,107 patients were admitted consecutively, among which 361 patients were with septic AKI. Patient clinical data were recorded daily for 10 days after admission. Kidney Disease: Improving Global Outcomes (KDIGO) criteria were used to define and stage AKI. Of the involved patients, 201 survived and 160 died. RESULTS The rate of septic AKI was 11.6%. Twenty-one risk factors were found, and six independent risk factors were identified: age, APACHE II score, duration of mechanical ventilation, duration of MAP <65 mmHg, time until RRT started, and progressive KIDGO stage. Admission KDIGO stages were not associated with mortality, while worst KDIGO stages were. Only progressive KIDGO stage was an independent risk factor. CONCLUSIONS Six independent risk factors for mortality for septic AKI were identified. Progressive KIDGO stage is better than admission or the worst KIDGO for prediction of mortality. This trial is registered with ChiCTR-ONC-11001875.