title: Sepsis may not be a risk factor for mortality in patients with acute kidney injury treated with continuous renal replacement therapy.
abstract: OBJECTIVE
  We aimed to study the clinical characteristics, courses, and outcomes of critically ill patients with septic acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT) in comparison with nonseptic AKI treated with CRRT.
  
  
  METHODS
  This is a multicenter retrospective observational study conducted in 14 Japanese intensive care units in 2010. All adult patients with severe AKI treated with CRRT were eligible (n = 343), and information on patient characteristics, variables at CRRT initiation, CRRT settings, and outcomes was collected. Patients were categorized into the septic AKI group and the nonseptic AKI group according to contributing factors to AKI.
  
  
  RESULTS
  Approximately half of study patients (48.7%) had sepsis/septic shock as a contributing factor to AKI, and patients with septic AKI treated with CRRT had more serious clinical conditions than patients with nonseptic AKI. However, no significant difference was observed in intensive care unit mortality (48.5% vs 43.8%; P = .44) and hospital mortality (61.1% vs 56.3%; P = .42) between patients with septic and nonseptic AKIs treated with CRRT. Furthermore, sepsis was associated with lower hospital mortality (odds ratio, 0.378; P = .012) in multivariable regression analysis.
  
  
  CONCLUSIONS
  Sepsis may not be a risk factor for mortality in patients with AKI whose condition has become severe enough to require CRRT.
authors.affiliation: Department of Emergency, Kanto Rosai Hospital, Kawasaki-shi, Kanagawa, Japan 211-8510. Electronic address: issaisao@gmail.com.
authors.forename: Isao
authors.initials: I
authors.lastname: Nagata
authors.affiliation: Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan 105-8471. Electronic address: s.uchino@mac.com.
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Uchino
authors.affiliation: Division of Intensive Care, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan 602-8566. Electronic address: natsueteto@yahoo.co.jp.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Tokuhira
authors.affiliation: Intensive Care Unit, Department of Anesthesiology, Saitama Medical Center, Jichi Medical University, Saitama-shi, Saitama, Japan 330-8503. Electronic address: tetsu.fe3@gmail.com.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Ohnuma
authors.affiliation: Department of Emergency and Critical Care, Showa University Fujigaoka Hospital, Yokohama-shi, Kanagawa, Japan 227-0043. Electronic address: irowa_nioedo@yahoo.co.jp.
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Namba
authors.affiliation: Department of Emergency Medicine, Asahi General Hospital, Asahi-shi, Chiba, Japan 289-2511. Electronic address: shinsyu_k@hotmail.com.
authors.forename: Shinshu
authors.initials: S
authors.lastname: Katayama
authors.affiliation: Department of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan 216-8511. Electronic address: hirookawarazaki@yahoo.co.jp.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Kawarazaki
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan 183-0042. Electronic address: vandervaart01jp@yahoo.co.jp.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Toki
authors.affiliation: Division of Intensive Care Medicine, Hyogo College of Medicine, Nishinomiya-shi, Hyogo, Japan 663-8501. Electronic address: takeda74@hyo-med.ac.jp.
authors.forename: Kenta
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Intensive Care Unit, Department of Emergency and Critical Care Medicine, Japanese Red Cross Musashino Hospital, Musashino-shi, Tokyo, Japan 180-8610. Electronic address: yasudahideto@me.com.
authors.forename: Hideto
authors.initials: H
authors.lastname: Yasuda
authors.affiliation: Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan 105-8471. Electronic address: jizawa13@gmail.com.
authors.forename: Junichi
authors.initials: J
authors.lastname: Izawa
authors.affiliation: Intensive Care Unit, Osaka University Hospital, Suita-shi, Osaka, Japan 565-0871. Electronic address: makiko.uj@gmail.com.
authors.forename: Makiko
authors.initials: M
authors.lastname: Uji
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D017582:Renal Replacement Therapy / Q000009:adverse effects / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D015996:Survival Rate
chemical_list: D015415:Biomarkers
keywords: Acute kidney injury; Continuous renal replacement therapy; Mortality; Sepsis