Tags

Type your tag names separated by a space and hit enter

Acute renal failure in patients with severe sepsis and septic shock--a significant independent risk factor for mortality: results from the German Prevalence Study.
Nephrol Dial Transplant. 2008 Mar; 23(3):904-9.ND

Abstract

BACKGROUND

Sound data about the prevalence of acute renal failure (ARF) among patients with severe sepsis and septic shock are lacking. Further, it is not known whether ARF is an independent risk factor for mortality in septic patients or merely an indicator of disease severity.

METHODS

A prospective cross-sectional one-day prevalence study was carried out in a representative sample of German ICUs, divided into five strata (< 200 beds; 201-400 beds; 401-600 beds; > 600 beds; university hospitals). 3877 patients were screened of whom 415 had severe sepsis and septic shock.

RESULTS

Fourteen patients (3.4%) had chronic dialysis-dependent RF and were excluded from analysis. Of the remaining 401 patients, 166 (41.4%) had ARF, as defined by a rise in creatinine above twice the upper limit of normal and/or a drop in urine output to < 0.5 ml/kg bodyweight. Median APACHE II score was 22 in patients with ARF and 16 in patients without ARF (p< 0.0001). Patients with severe sepsis/septic shock had an overall hospital mortality of 55.2%. Hospital mortality in patients with ARF was 67.3% and without ARF 42.8% (p< 0.0001). After adjustment for APACHE II score and age, ARF remained a significant independent risk factor for death [odds ratio (OR) 2.11, 95% confidence interval (CI) 1.27-3.52]. Mortality in septic patients was not associated with pre-existing, non-dialysis-dependent chronic kidney disease, whereas in dialysis-dependent patients with sepsis mortality increased to 86%.

CONCLUSION

In this representative survey in patients with severe sepsis/septic shock, prevalence of ARF is high with 41.4%. ARF represents a significant independent risk factor for mortality in these patients.

Authors+Show Affiliations

Department of Nephrology and Medical Intensive Care, Charité Universitätsmedizin Berlin, Humboldt University, 13353 Berlin, Germany. oppert@charite.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18065435

Citation

Oppert, Michael, et al. "Acute Renal Failure in Patients With Severe Sepsis and Septic Shock--a Significant Independent Risk Factor for Mortality: Results From the German Prevalence Study." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 23, no. 3, 2008, pp. 904-9.
Oppert M, Engel C, Brunkhorst FM, et al. Acute renal failure in patients with severe sepsis and septic shock--a significant independent risk factor for mortality: results from the German Prevalence Study. Nephrol Dial Transplant. 2008;23(3):904-9.
Oppert, M., Engel, C., Brunkhorst, F. M., Bogatsch, H., Reinhart, K., Frei, U., Eckardt, K. U., Loeffler, M., & John, S. (2008). Acute renal failure in patients with severe sepsis and septic shock--a significant independent risk factor for mortality: results from the German Prevalence Study. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 23(3), 904-9.
Oppert M, et al. Acute Renal Failure in Patients With Severe Sepsis and Septic Shock--a Significant Independent Risk Factor for Mortality: Results From the German Prevalence Study. Nephrol Dial Transplant. 2008;23(3):904-9. PubMed PMID: 18065435.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute renal failure in patients with severe sepsis and septic shock--a significant independent risk factor for mortality: results from the German Prevalence Study. AU - Oppert,Michael, AU - Engel,Christoph, AU - Brunkhorst,Frank-Martin, AU - Bogatsch,Holger, AU - Reinhart,Konrad, AU - Frei,Ulrich, AU - Eckardt,Kai-Uwe, AU - Loeffler,Markus, AU - John,Stefan, AU - ,, Y1 - 2007/12/07/ PY - 2007/12/11/pubmed PY - 2008/4/24/medline PY - 2007/12/11/entrez SP - 904 EP - 9 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 23 IS - 3 N2 - BACKGROUND: Sound data about the prevalence of acute renal failure (ARF) among patients with severe sepsis and septic shock are lacking. Further, it is not known whether ARF is an independent risk factor for mortality in septic patients or merely an indicator of disease severity. METHODS: A prospective cross-sectional one-day prevalence study was carried out in a representative sample of German ICUs, divided into five strata (< 200 beds; 201-400 beds; 401-600 beds; > 600 beds; university hospitals). 3877 patients were screened of whom 415 had severe sepsis and septic shock. RESULTS: Fourteen patients (3.4%) had chronic dialysis-dependent RF and were excluded from analysis. Of the remaining 401 patients, 166 (41.4%) had ARF, as defined by a rise in creatinine above twice the upper limit of normal and/or a drop in urine output to < 0.5 ml/kg bodyweight. Median APACHE II score was 22 in patients with ARF and 16 in patients without ARF (p< 0.0001). Patients with severe sepsis/septic shock had an overall hospital mortality of 55.2%. Hospital mortality in patients with ARF was 67.3% and without ARF 42.8% (p< 0.0001). After adjustment for APACHE II score and age, ARF remained a significant independent risk factor for death [odds ratio (OR) 2.11, 95% confidence interval (CI) 1.27-3.52]. Mortality in septic patients was not associated with pre-existing, non-dialysis-dependent chronic kidney disease, whereas in dialysis-dependent patients with sepsis mortality increased to 86%. CONCLUSION: In this representative survey in patients with severe sepsis/septic shock, prevalence of ARF is high with 41.4%. ARF represents a significant independent risk factor for mortality in these patients. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/18065435/Acute_renal_failure_in_patients_with_severe_sepsis_and_septic_shock__a_significant_independent_risk_factor_for_mortality:_results_from_the_German_Prevalence_Study_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfm610 DB - PRIME DP - Unbound Medicine ER -