Risk Factors for Development of Acute Kidney Injury in Patients with Urinary Tract Infection

• Published in: PloS one Vol. 10; no. 7; p. e0133835
• Main Authors: Hsiao, Chih-Yen, Yang, Huang-Yu, Hsiao, Meng-Chang, Hung, Peir-Haur, Wang, Ming-Cheng
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 27.07.2015; Public Library of Science (PLoS)
• Subjects: Acute Kidney Injury - etiology; Acute Kidney Injury - physiopathology; Aged; Aged, 80 and over; Antibiotics; Bacterial infections; Cardiovascular disease; Comorbidity; Demographics; Diabetes; Diabetes mellitus; Epidemiology; Epidermal growth factor receptors; Female; Glomerular Filtration Rate; Health aspects; Heart surgery; Hospitalization; Hospitals; Humans; Infections; Internal medicine; Kidney diseases; Kidneys; Male; Medical personnel; Medicine; Middle Aged; Morbidity; Mortality; Nephrology; Odds Ratio; Patients; Pharmacy; Physicians; Regression analysis; Renal function; Retrospective Studies; Review boards; Risk analysis; Risk Factors; Sepsis; Septic shock; Studies; Urinary tract; Urinary tract diseases; Urinary tract infections; Urinary Tract Infections - complications; Urogenital system
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0133835

Acute kidney injury (AKI) is associated with high morbidity and mortality. Urinary tract infection (UTI) may be associated with sepsis or septic shock, and cause sudden deterioration of renal function. This study investigated the clinical characteristics and change of renal function to identify the risk factors for development of AKI in UTI patients. This retrospective study was conducted in a tertiary referral center. From January 2006 to January 2013, a total of 790 UTI patients necessitating hospital admission were included for final analysis. Their demographic and clinical characteristics and comorbidities were collected and compared. Multivariate logistic regression analysis was performed to evaluate the risk factors for AKI in UTI patients. There were 97 (12.3%) patients developing AKI during hospitalization. Multivariate logistic regression analysis showed that patients with older age (OR 1.02, 95% CI 1.00-1.04, P = 0.04), diabetes mellitus (DM) (OR 2.23, 95% CI 1.35-3.68, P = 0002), upper UTI (OR 2.63, 95% CI 1.53-4.56, P = 0001), afebrile during hospitalization (OR 1.71, 95% CI 1.04-2.83, P = 0036) and lower baseline eGFR [baseline eGFR 45-59 mL/min/1.73 m2 (OR 2.12, 95% CI 1.12-4.04, P = 0.022), baseline eGFR 30-44 mL/min/1.73 m2 (OR 4.44, 95% CI 2.30-8.60 P < 0.001) baseline eGFR < 30 mL/min/1.73 m2 (OR 4.72, 95% CI 2.13-10.45, P <0.001), respectively] were associated with increased risk for development of AKI. were associated with increased risk for development of AKI. Physicians should pay attention to UTI patients at risk of AKI (advancing age, DM, upper UTI, afebrile, and impaired baseline renal function).