Impact of End-Stage Renal Disease and Acute Kidney Injury on ICU Outcomes in Patients With Sepsis

J Intensive Care Med. 2017 Aug;32(7):444-450. doi: 10.1177/0885066616645308. Epub 2016 May 4.


Purpose: 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.

Conclusion: 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.

Keywords: acute kidney injury; end-stage renal disease; nonkidney injury; sepsis.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Kidney Injury / complications*
  • Adult
  • Aged
  • Databases, Factual
  • Female
  • Hospital Mortality
  • Hospitalization / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Kidney Failure, Chronic / complications*
  • Male
  • Middle Aged
  • Patient Outcome Assessment*
  • Retrospective Studies
  • Sepsis / etiology
  • Sepsis / mortality*