title: Septic versus non-septic acute kidney injury in critically ill patients: characteristics and clinical outcomes.
abstract: OBJECTIVE
  This study aimed to describe and compare the characteristics and clinical outcomes of patients with septic and non-septic acute kidney injury.
  
  
  METHODS
  This study evaluated an open cohort of 117 critically ill patients with acute kidney injury who were consecutively admitted to an intensive care unit, excluding patients with a history of advanced-stage chronic kidney disease, kidney transplantation, hospitalization or death in a period shorter than 24 hours. The presence of sepsis and in-hospital death were the exposure and primary variables in this study, respectively. A confounding analysis was performed using logistic regression.
  
  
  RESULTS
  No significant differences were found between the mean ages of the groups with septic and non-septic acute kidney injury [65.30±21.27 years versus 66.35±12.82 years, respectively; p=0.75]. In the septic and non-septic acute kidney injury groups, a predominance of females (57.4% versus 52.4%, respectively; p=0.49) and Afro-descendants (81.5% versus 76.2%, respectively; p=0.49) was observed. Compared with the non-septic patients, the patients with sepsis had a higher mean Acute Physiology and Chronic Health Evaluation II score [21.73±7.26 versus 15.75±5.98; p<0.001)] and a higher mean water balance (p=0.001). Arterial hypertension (p=0.01) and heart failure (p<0.001) were more common in the non-septic patients. Septic acute kidney injury was associated with a greater number of patients who required dialysis (p=0.001) and a greater number of deaths (p<0.001); however, renal function recovery was more common in this group (p=0.01). Sepsis (OR: 3.88; 95%CI: 1.51-10.00) and an Acute Physiology and Chronic Health Evaluation II score >18.5 (OR: 9.77; 95%CI: 3.73-25.58) were associated with death in the multivariate analysis.
  
  
  CONCLUSIONS
  Sepsis was an independent predictor of death. Significant differences were found between the characteristics and clinical outcomes of patients with septic versus non-septic acute kidney injury.
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.
authors.forename: Marília Galvão
authors.initials: MG
authors.lastname: Cruz
authors.affiliation: Faculdade de Tecnologia e Ciência, Salvador, BA, Brasil.
authors.forename: João Gabriel Athayde de Oliveira
authors.initials: JG
authors.lastname: Dantas
authors.affiliation: Universidade Estadual de Santa Cruz, Itabuna, BA, Brasil.
authors.forename: Talita Machado
authors.initials: TM
authors.lastname: Levi
authors.affiliation: Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.
authors.forename: Mário de Seixas
authors.initials: Mde S
authors.lastname: Rocha
authors.affiliation: Programa de Residência em Clínica Médica, Hospital Santo Antônio, Obras Sociais Irmã Dulce, Salvador, BA, Brasil.
authors.forename: Sérgio Pinto
authors.initials: SP
authors.lastname: de Souza
authors.affiliation: Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.
authors.forename: Ney
authors.initials: N
authors.lastname: Boa-Sorte
authors.affiliation: Programa de Residência em Clínica Médica, Hospital Santo Antônio, Obras Sociais Irmã Dulce, Salvador, BA, Brasil.
authors.forename: Carlos Geraldo Guerreiro
authors.initials: CG
authors.lastname: de Moura
authors.affiliation: Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.
authors.forename: Constança Margarida Sampaio
authors.initials: CM
authors.lastname: Cruz
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018805:Sepsis / Q000150:complications*