Ou Shuo-Ming, Lee Kuo-Hua, Tsai Ming-Tsun, Tseng Wei-Cheng, Chu Yuan-Chia, Tarng Der-Cherng
Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Front Med (Lausanne). 2022 Feb 24;9:809292. doi: 10.3389/fmed.2022.809292. eCollection 2022.
Sepsis is known to cause renal function fluctuations during hospitalization, but whether these patients discharged from sepsis were still at greater risks of long-term renal adverse outcomes remains unknown.
From 2011 to 2018, we included 1,12,628 patients with chronic kidney disease (CKD) aged ≥ 20 years. The patients with CKD were further divided into 11,661 sepsis group and 1,00,967 non-sepsis group. The following outcome of interest was included: all-cause mortality, readmission for acute kidney injury, estimated glomerular filtration rate decline ≥50% or doubling of serum creatinine, and end-stage renal disease.
After propensity score matching, the sepsis group was at higher risks of all-cause mortality [hazard ratio (HR) 1.39, 95% CI, 1.31-1.47], readmission for acute kidney injury (HR 1.67, 95% CI 1.58-1.76), eGFR decline ≥ 50% or doubling of serum creatinine (HR 3.34, 95% CI 2.78-4.01), and end-stage renal disease (HR 1.43, 95% CI 1.34-1.53) than non-sepsis group.
Our study found that patients with CKD discharged from hospitalization for sepsis have higher risks of subsequent renal adverse events.
脓毒症已知会在住院期间导致肾功能波动，但这些脓毒症出院患者是否仍面临更高的长期肾脏不良结局风险尚不清楚。
2011年至2018年，我们纳入了112628例年龄≥20岁的慢性肾脏病（CKD）患者。CKD患者进一步分为11661例脓毒症组和100967例非脓毒症组。纳入以下感兴趣的结局：全因死亡率、急性肾损伤再入院、估计肾小球滤过率下降≥50%或血清肌酐翻倍以及终末期肾病。
倾向评分匹配后，脓毒症组在全因死亡率[风险比（HR）1.39，95%可信区间（CI），1.31 - 1.47]、急性肾损伤再入院（HR 1.67，95%CI 1.58 - 1.76）、估算肾小球滤过率（eGFR）下降≥50%或血清肌酐翻倍（HR 3.34，95%CI 2.78 - 4.01）以及终末期肾病（HR 1.43，95%CI 1.34 - 1.53）方面的风险均高于非脓毒症组。
我们的研究发现，因脓毒症住院出院的CKD患者随后发生肾脏不良事件的风险更高。
