Impact of Non-dialysis Chronic Kidney Disease on Survival in Patients with Septic Shock

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2013 Apr 4

PMID 23548034

Citations 16

Authors

Julien Maizel

Romain Deransy

Benedicte Dehedin

Edouard Secq

Elie Zogheib

Elisabeth Lewandowski

Chritstophe Tribouilloy

Ziad A Massy

Gabriel Choukroun

Michel Slama

Affiliations

Soon will be listed here.

Abstract

Background: Chronic kidney disease (CKD) is known to expose the patient to a high risk of death due to cardiovascular and infective causes. In parallel, septic shock is a major challenge for cardiovascular and immune system. Therefore we tried to determine whether non-dialysis CKD, defined as a baseline estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, for three months prior to the onset of septic shock is an independent risk factor for death.

Methods: All patients treated in a teaching hospital medical ICU for septic shock between January 2007 and December 2009 were retrospectively analyzed. Patients in whom baseline eGFR could not be determined (n=14) or patients treated by chronic dialysis (n=21) or kidney transplantation (n=14) were excluded. A total of 163 patients were included. The population was divided according to baseline eGFR ≥ 60 ml/min/1.73 m2 (non-CKD group, n=107) and < 60 ml/min/1.73 m2 (CKD group, n=56). Twenty-eight-day and 1-year survival curves were plotted. Prognostic factors were determined using Cox proportional hazards models.

Results: Baseline eGFR was significantly higher in the non-CKD group than in the CKD group (81 (67-108) vs. 36 (28-44) ml/min/1.73 m2, respectively; p=0.001). Age, SAPS II, serum creatinine on admission and the number of patients with a history of diabetes, hypertension, heart failure, peripheral artery disease, coronary artery disease and statin medication were significantly higher in the CKD group than in the non-CKD group. The mortality rate was lower in the non-CKD group than in the CKD group after 28 days (50% vs. 70%, respectively; p=0.03) and 1 year (64% vs. 82%, respectively; p=0.03). On multivariate analysis, the dichotomous variable CKD (eGFR < 60 ml/min/1.73 m2) remained significantly associated with the 28-day and 1-year mortality.

Conclusions: Non-dialysis CKD appears to be an independent risk factor for death after septic shock.

Citing Articles

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Altered Lung Heat Shock Protein-70 Expression and Severity of Sepsis-Induced Acute Lung Injury in a Chronic Kidney Disease Rat Model.

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The Risk Factors for Mortality among Septic Trauma Patients: A Retrospective Cohort Study Using the National Trauma Data Bank.

Kattouf N, Assaf M, Haidar S, Bachir R, El Sayed M, BouChebl R Emerg Med Int. 2023; 2022:6386078.

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Does chronic kidney disease affect the complications and prognosis of patients after primary colorectal cancer surgery?.

Liu X, Zhang B, Cheng Y, Tao W, Yuan C, Wei Z World J Gastrointest Oncol. 2022; 14(6):1199-1209.

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