title: Impact of End-Stage Renal Disease and Acute Kidney Injury on ICU Outcomes in Patients With Sepsis.
abstract: OBJECTIVE
  To report the characteristics and outcomes of patients with sepsis in the intensive care unit (ICU) with end-stage renal disease (ESRD) and acute kidney injury (AKI) compared to patients with nonkidney injury (non-KI).
  
  
  METHODS
  Retrospective study of all patients with sepsis admitted to the ICU of a university hospital within a 12-month time period. Data were obtained from the University Health Consortium database and a chart review of the electronic medical records.
  
  
  RESULTS
  We identified 39 cases of ESRD, 106 cases of AKI, and 103 cases of non-KI. Intensive care unit mortality was 15.4% for ESRD, 30.2% for AKI, and 13.6% for non-KI ( P < .01). Hospital mortality was 20.5% for ESRD, 32.1% for AKI, and 13.6% for non-KI ( P < .01). Early AKI and late AKI had an ICU mortality of 24.4% versus 50% ( P <.01), hospital mortality of 26.8% versus 50% ( P = .03), ICU length of stay (LOS) of 3 and 6 days ( P = .04), and hospital LOS of 7 and 12.5 days ( P <.01), respectively.
  
  
  CONCLUSIONS
  Patients with sepsis having AKI have a higher mortality rate than those with ESRD and non-KI. Hospital and ICU mortality rates for patients with ESRD were similar to non-KI patients. Late AKI compared to early AKI had a higher mortality and longer LOS.
authors.affiliation: 1 Division of Pulmonary and Critical Care Medicine, Rush University Medical Center and Rush Medical College, Chicago, IL, USA.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Jeganathan
authors.affiliation: 2 Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Neha
authors.initials: N
authors.lastname: Ahuja
authors.affiliation: 2 Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Yau
authors.affiliation: 2 Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Dara
authors.initials: D
authors.lastname: Otu
authors.affiliation: 1 Division of Pulmonary and Critical Care Medicine, Rush University Medical Center and Rush Medical College, Chicago, IL, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Stein
authors.affiliation: 1 Division of Pulmonary and Critical Care Medicine, Rush University Medical Center and Rush Medical College, Chicago, IL, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Balk
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications*; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology / Q000401:mortality*
keywords: acute kidney injury; end-stage renal disease; nonkidney injury; sepsis