Impact of Acute Kidney Injury on Clinical Outcomes of Patients with Sepsis Admitted to Intensive Care Units

Abstract

Sepsis-associated acute kidney injury (SA-AKI) is one of the most frequent and severe complications observed in patients admitted to intensive care units and is associated with increased morbidity, mortality, and healthcare resource utilization. This study aimed to analyze the clinical outcomes of patients with concomitant sepsis and acute kidney injury admitted to intensive care units through an integrative literature review. The search was conducted in scientific databases using descriptors related to sepsis, acute kidney injury, and intensive care. Initially, 67 potentially relevant studies were identified. After applying eligibility criteria and full-text assessment, nine studies were selected for the final sample. The findings demonstrated a high incidence of SA-AKI among critically ill patients, affecting approximately one out of every six ICU admissions. The presence of acute kidney injury was associated with increased hospital mortality, greater need for mechanical ventilation, renal replacement therapy, vasoactive drug support, and prolonged hospital stay. Furthermore, elevated lactate levels, higher SOFA scores, septic shock, and persistent reduction in urine output were identified as factors associated with the development and progression of kidney injury. Persistent forms of SA-AKI were also associated with significantly worse outcomes compared to transient injury. It is concluded that sepsis-associated acute kidney injury is an important prognostic marker in critically ill patients, highlighting the need for early identification, continuous renal function monitoring, and targeted therapeutic strategies to minimize adverse clinical outcomes.