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Year : 2020  |  Volume : 4  |  Issue : 2  |  Page : 58-65

Thirty-day outcomes among intensive care unit patients with septic shock with versus without preadmission chronic renal disease

1 Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
2 Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

Correspondence Address:
Haifa Mesfer Algethamy
Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sccj.sccj_8_20

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Background: Considerable research indicates that experiencing acute kidney injury (AKI) during hospitalization from sepsis increases patients' risk of death, but few data exist on whether preexisting renal disease, irrespective of the need for dialysis, also increases mortality. Objectives: The objectives of this study were to identify if preexisting renal disease alters outcomes in patients admitted to a Saudi Arabian, tertiary-care intensive care unit (ICU) for septic shock. Materials and Methods: All patients ≥14 years old admitted to the ICU for septic shock from December 2015 to January 2017 were enrolled prospectively and followed for a minimum of 30 days or until death or hospital discharge. Patients with versus without preexisting renal disease were compared regarding demographic and baseline clinical characteristics, details of their infection and treatment, and outcomes. Results: Among 161 patients (mean age: 61.6; male:female = 1:1), 33 had some documented, preexisting renal disease, among whom 17 required regular dialysis. Among the 128 without preexisting renal disease, 66 (52%) died in hospital, versus 11 of 17 (65%) and 9 of 16 (56%) with kidney disease requiring and not requiring dialysis, respectively. Both the presence of renal dysfunction and the development of new-onset AKI were borderline linked to increased, inhospital mortality (P = 0.051 and 0.080, respectively). However, the presence of preexisting renal disease, with or without the need for dialysis, was nonsignificantly (P = 0.58) linked to increased, inhospital mortality. Conclusions: In our sample of 161 patients with septic shock, the presence of preexisting renal disease was not associated with increased mortality, but new-onset AKI and the presence of renal dysfunction in the ICU both were associated with increased mortality.

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