Long-term Renal Outcomes in Adults With Sepsis-Induced Acute Kidney Injury: A Systematic Review.

ABSTRACT

BACKGROUND: Despite advances in medical technologies and intervention occurrences, acute kidney injury (AKI) incidence continues to rise. Early interventions after sepsis are essential to prevent AKI and its long-term consequences. Acute kidney injury is the leading cause of organ failure in sepsis; therefore, more research is needed on its long-term consequences and progression to kidney injury. OBJECTIVES: The aim of this study was to review the state of the science on long-term renal outcomes after sepsis-induced AKI and long-term renal consequences. METHODS: We identified research articles from PubMed and CINAHL databases using relevant key words for sepsis-induced AKI within 5 years delimited to full-text articles in English. RESULTS: Among 1280 abstracts identified, we ultimately analyzed 12 full-text articles, identifying four common themes in the literature (1) AKI determination criteria, (2) severity/prognosis-related factors, (3) time frame for long-term outcome measures, and (4) chronic kidney disease (CKD) and renal related exclusions. Researchers primarily used KDIGO (Kidney Disease Improving Global Outcomes) guidelines to define AKI. All of these studies excluded patients with CKD. The range of time for long-term renal outcomes was 28 days to 3 years, with the majority being 1 year. Renal outcomes ranged from recovery to renal replacement therapy to death. CONCLUSIONS: To better understand the long-term renal outcomes after sepsis-induced AKI, more consistent measures are needed across all studies regarding the time frame and specific renal outcomes. Because all of these articles excluded patients with CKD, a gap exists on long-term renal outcome in acute on CKD.