Journal of Internal Medicine Concepts & Practice >

2021 , Vol. 16 >Issue 01: 22 - 26

DOI: https://doi.org/10.16138/j.1673-6087.2021.01.006

Original article

Risk factors of acute kidney injury in the patients with bloodstream infection caused by different pathogens

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  • a. Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    b. Department of Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2021-01-04

  Online published: 2022-07-26

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Abstract

Objective To investigate the incidence, risk factors and prognosis of acute kidney injury(AKI) in the patients with bloodstream infection caused by different pathogens. Methods From January 1, 2018 to December 31, 2018, the patients with blood stream infection in our hospital were enrolled and four most common pathogens including Klebsiella pneumoniae, Escherichia coli, coagulase-negative Staphylococcus and Staphylococcus aureus were tested and total 348 patients were included in this study. The basic information, biochemical indicators during hospitalization and the time and type of invasive procedures before positive blood culture of patients were collected. In accordance with Kidney Disease: Improving Global Outcomes(KDIGO) AKI diagnostic criteria, the definition of AKI was an creatinine increase ≥26.5 μmol/L within 48 h or an 1.5 time increase than the baseline creatinine level within 1 week. The Logistic regression analysis was used to analyze the risk factors, incidence, and prognosis of AKI in the patients with bloodstream infection caused by different pathogens. Results A total of 348 patients with positive blood culture were included in this study. Among them, 70 patients (20.1%) developed AKI. The incidence of AKI was 23.3%, 22.2%, 22% and 15.1% in the patients infected with Staphylococcus aureus, coagulase negative Staphylococcus, Klebsiella pneumoniae and Escherichia coli, respectively. The basic creatinine in the patients with AKI was (80.01±37.09) μmol/L, which was significantly higher than that in the cases without AKI [(69.98±46.40) μmol/L, P=0.008], and the patients in the AKI group received more invasive procedures (70.0% vs 34.5%, P=0.001). Multivariate Logistic regression analysis showed that the invasive procedures were risk factors for AKI patients with bloodstream infection caused by different pathogens [odds ratio(OR)=3.25, 95% confidence interval (CI): 1.80-5.89, P<0.001]. The incidence of AKI (χ2=2.42, P=0.49), kidney function recovery (χ2=6.40, P=0.09) and mortality (χ2=2.40, P=0.49) in bloodstream infection caused by different pathogens didn’t show statistical difference. Conclusions The invasive procedures are risk factors for AKI in the patients with bloodstream infection caused by different pathogens. There is no statistical difference in the incidence and prognosis of AKI among the patients with bloodstream infection caused by different pathogens.

Key words： Pathogen; Bloodstream infection; Acute kidney injury; Creatinine; Sepsis

Cite this article

WANG Xuejie, CHEN Zijin, DU Wen, GU Feifei, YU Haijin, ZHANG Wen, CHEN Xiaonong . Risk factors of acute kidney injury in the patients with bloodstream infection caused by different pathogens[J]. Journal of Internal Medicine Concepts & Practice, 2021 , 16(01) : 22 -26 . DOI: 10.16138/j.1673-6087.2021.01.006

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