No impact of surviving sepsis campaign care bundles in reducing sepsis-associated acute kidney injury

• Published in: Clinical nephrology Vol. 88; no. 8; pp. 105 - 111
• Main Authors: Pérez-Fernández, Xosé, Sabater-Riera, Joan, Ballus-Noguera, Josep, Cárdenas-Campos, Paola, Moreno-González, Gabriel, Alonso-Juste, Virginia, Corral-Velez, Vicente, Gutierrez-Arámbula, Diana, Gumucio-Sanguino, Victor, Betbesé-Roig, Antoni, Liu, Kathleen D
• Format: Journal Article
• Language: English
• Published: Germany Dustri - Verlag Dr. Karl Feistle GmbH & Co. KG 01.08.2017
• Subjects: Acute Kidney Injury - prevention & control; Adult; Aged; Blood pressure; Cohort Studies; Creatinine; Critical care; Female; Hospitals; Humans; Hypotension; Kidneys; Male; Middle Aged; Mortality; Nephrology; Oliguria; Patient Care Bundles; Risk factors; Sepsis; Sepsis - complications; Sepsis - mortality; Shock, Septic - complications; Shock, Septic - mortality; Urine; Ventilators
• ISSN: 0301-0430
• DOI: 10.5414/CN109134

The impact of Surviving Sepsis Campaign (SSC) care bundles in reducing sepsis-associated acute kidney injury (SA-AKI) was evaluated. We conducted an observational single-center cohort study. Accomplishment of SSC care bundles was registered in all patients with severe sepsis admitted to the critical care department of a university hospital during three different periods. The main outcome measured was SA-AKI incidence defined as any worsening of AKI stage within the first 7 days from onset of sepsis. Among 260 patients with severe sepsis or septic shock finally meeting inclusion criteria, 82 (31.5%) patients developed SA-AKI. None of the SSC care tasks significantly decreased SA-AKI incidence, although a trend was observed with an initial better blood glucose control as well as with a more protective ventilation strategy. Hypotension requiring fluid challenge (hazard ratio (HR), 2.3; 95% confidence interval (CI), 1.2 - 4.2) and the presence of an abdominal sepsis etiology (HR, 1.8; 95% CI, 1.1 - 3.1) were independently associated with SA-AKI. Patients who developed SA-AKI had a higher 90-day mortality rate (62.2 vs. 40.4%). In a cohort of septic patients, none of the SSC care tasks significantly decreased SA-AKI incidence within the first week after onset of sepsis.
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