Acute kidney injury in patients with severe sepsis in F innish I ntensive C are U nits

Background Severe sepsis is one of the leading causes of acute kidney injury ( AKI ). Patients with sepsis‐associated AKI demonstrate high‐hospital mortality. We evaluated the incidence of severe sepsis‐associated AKI and its association with outcome in intensive care units ( ICU s) in F inland. Methods This was a predetermined sub‐study of the prospective, observational, multicentre FINNAKI study conducted in 17 ICU s during 1 S eptember 2011 and 1 F ebruary 2012. All emergency ICU admissions and elective admissions exceeding 24 hours in the ICU were screened for presence of severe sepsis and AKI up to 5 days in ICU . AKI was defined according to the K idney D isease: I mproving G lobal O utcomes ( KDIGO ) criteria and severe sepsis according to the American College of Chest Physicians/Society of Critical Care Medicine ( ACCP / SCCM ) criteria. Results Of the 2901 included patients, severe sepsis was diagnosed in 918 (31.6%, 95% confidence interval [ CI ] 29.9–33.4%) patients. Of these 918 patients, 488 (53.2% [95% CI 49.9–56.5%]) had AKI . The 90‐day mortality rate was 38.1% (95% CI 33.7–42.5%) for severe sepsis patients with AKI and 24.7% (95% CI 20.5–28.8%) for those without AKI . After adjusting for covariates, KDIGO stage 3 AKI was associated with an increased risk for 90‐day mortality with an adjusted odds ratio ( OR ) of 1.94 (95% CI 1.28–2.94), but stages 1 and 2 were not. Conclusions More than half of the patients with severe sepsis had AKI according to the KDIGO classification, and AKI stage 3 was independently associated with 90‐day mortality.