Risk factors for acute kidney injury in critically ill patients with complicated intra-abdominal infection.

PURPOSE: The aim was to determine the factors related to acute kidney injury (AKI) in surgical septic patients with complicated intra-abdominal infection (CIAI) and mortality associated to AKI. METHODS: An observational study was performed in patients with CIAI requiring surgery and ICU admission (June 2011-June 2013). Factors at admission associated with developing of AKI and renal replacement therapy (RRT) and association between mortality and AKI and RRT were studied. RESULTS: A total of 114 patients were included. Developing of AKI was independently associated with the sequential organ failure assessment (SOFA) score (odds ratio [OR], 1.570; 95% confidence interval [CI], 1.286-2.016) and creatinine at admission (OR for 0.1 units, 1.560; 95% CI, 1.296-1.990). Renal replacement therapy was independently associated with arterial hypertension (OR, 4.896; 95% CI, 1.501-15.971) and SOFA (OR, 1.713; 95% CI, 1.377-2.132). In another model with more predictive capacity, the number of previous medications that may alter renal function (OR, 3.732; 95% CI, 1.923-8.383) and SOFA (OR, 1.860; 95% CI, 1.469-2.541) were related to RRT. Both AKI and RRT were related to intensive care unit (P=.014 and P<.001, respectively) and 28-day mortality (P=.045 and P<.001, respectively). CONCLUSIONS: Acute kidney injury in patients with CIAI is clearly associated with SOFA and creatinine at admission. Severe AKI with RRT need is highly associated with both previous arterial hypertension and the number of previous medications potentially affecting renal function.