title: Renal Function Outcome Prognosis in Septic and Non-septic Acute Kidney Injury Patients.
abstract: OBJECTIVE
  The objective of this study was to evaluate prognostic impact of clinical factors on outcome of renal function in septic and non-septic acute kidney injury (AKI) patients.
  
  
  METHODS
  The prospective, observational, clinical study was performed at Nephrology Clinic and Clinic for Infectious Diseases, University Clinical Centre Sarajevo. One hundred patients with diagnosis of AKI were enrolled in the study, and divided into two groups: septic and non-septic AKI patients. Clinical parameters included causes and type of AKI, pre-existing comorbidities and different treatment modalities. Patients were followed up until discharge or death. Renal function outcome was defined by creatinine clearance values at discharge.
  
  
  RESULTS
  Septic AKI patients had significantly longer hospital stay (p=0.03), significantly worse renal function outcome (p<0.001), and higher burden of comorbidities (70.6% vs. 60.6%), compared to non-septic patients. Septic AKI patients were almost three times less likely to receive renal replacement therapy (8.8% vs. 24.4%) and they had significant delay in initiation of dialysis (p=0.03). By multivariate analysis, sepsis (95% CI 0.128-0.967, p=0.043) and hypertension (95% CI 0.114-0.788, p=0.015) were independent predictors of adverse renal function outcome in AKI patients. Postrenal type of AKI was independent predictor of renal function recovery in non-septic AKI patients (95% CI 1.174-92.264, p=0.035), while Failure, as third class of AKI, was independent predictor of non-recovered renal function only in septic AKI patients (95% CI 0.026 to 0.868, p=0.034).
  
  
  CONCLUSIONS
  Septic AKI patients are clinically distinct compared to non-septic AKI patients with different prognostic factors and poorer renal function outcome.
authors.affiliation: University Clinical Centre Sarajevo, Nephrology Clinic, Sarajevo, Bosnia and Herzegovina.
authors.forename: Aida
authors.initials: A
authors.lastname: Hamzic-Mehmedbasic
authors.affiliation: University Clinical Centre Sarajevo, Nephrology Clinic, Sarajevo, Bosnia and Herzegovina.
authors.forename: Senija
authors.initials: S
authors.lastname: Rasic
authors.affiliation: University Clinical Centre Sarajevo, Nephrology Clinic, Sarajevo, Bosnia and Herzegovina.
authors.forename: Damir
authors.initials: D
authors.lastname: Rebic
authors.affiliation: University Clinical Centre Sarajevo, Clinic for Heart Disease and Rheumatism, Sarajevo, Bosnia and Herzegovina.
authors.forename: Azra
authors.initials: A
authors.lastname: Durak-Nalbantic
authors.affiliation: University Clinical Centre Sarajevo, Nephrology Clinic, Sarajevo, Bosnia and Herzegovina.
authors.forename: Alma
authors.initials: A
authors.lastname: Muslimovic
authors.affiliation: University Clinical Centre Sarajevo, Nephrology Clinic, Sarajevo, Bosnia and Herzegovina.
authors.forename: Jasminka
authors.initials: J
authors.lastname: Dzemidzic
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis; D018805:Sepsis / Q000150:complications* / Q000175:diagnosis
chemical_list: D003404:Creatinine
keywords: acute kidney injury; prognostic factors; renal function outcome; septic etiology