Analysis Of Related Factors Of Acute Kidney Injury In ICU Patients With Sepsis

Background:The incidence rate of acute kidney injury in sepsis patients is high and mortality is high in ICU.Analysis of the risk factors of acute kidney injury is of great significance for prevention and early intervention.However,there are few researches on this aspect,and there are few references for clinical use.Objective:To explore the related risk factors of acute kidney injury in patients with sepsis in the Intensive Care Unit(ICU)in Shiyan District,Hubei Province,in order to detect early and improve the prognosis of patients with sepsis and acute kidney injury.Methods:The clinical data of 186 patients with sepsis who were admitted to the intensive care unit of Shiyan City People’s Hospital from January 2016 to January 2019 were collected for research.According to whether there is acute kidney injury,the patients were divided into control group and experimental group.The incidence rate,mortality rate and etiology of acute kidney injury in sepsis patients were analyzed.The causes of acute kidney injury were analyzed by logistic regression.Objective to investigate the effect of leptin on the prognosis of the disease.Results:1.In the intensive care unit,the survival rate of patients with sepsis complicated by acute kidney injury had a 28-day follow-up survival rate of 34%and a mortality rate of 66%.The age factor was statistically significant in patients with sepsis and acute kidney injury(P<0.05).Other data such as gender and previous medical history were not statistically significant.2.Comparison of general clinical data between the simple sepsis patient group and the sepsis complicated acute kidney injury group:chronic renal insufficiency,age and other factors are statistically significant between the two(P<0.05),other data are not has statistical significane.Univariate analysis suggests that compared with the simple sepsis group,the serum K+ion concentration,HCO3-ion concentration,sepsis grading severity,and APACHE Ⅱ score are more statistical significance in the sepsis combined with acute kidney injury group(P<0.05).Multivariate logistic regression analysis showed that MAP,SAPS Ⅱ score,APACHE Ⅱ score,and sepsis grade were independent risk factors for acute kidney injury in patients with sepsis.3.Objective to analyze the treatment,laboratory examination and prognosis of patients with sepsis complicated with acute kidney injury,univariate analysis suggests that the risk factors affecting prognosis include age,albumin,serum K+ ion concentration,CRP,MAP,APACHE Ⅱ score,sepsis grade,whether to support mechanical ventilation,the number of organ failures,and LDH concentration.Results There is a statistical difference(P<0.05).Multivariate logistic regression analysis showed that in the survival and death group of patients with sepsis and acute kidney injury,the number of organ failure,MAP,APACHE Ⅱ score,whether mechanical ventilation was performed,albumin,serum K+ion concentration and other data were statistically available It is of scientific significance(P<0.05),and these factors are independent risk factors for the patient’s death within 28 days.4.Continuous Renal Replacement Therapy(CRRT)is not statistically significant for the 28-day survival of patients with sepsis and acute kidney injury.The survival curve of patients undergoing CRRT treatment is significantly higher than that of patients not undergoing CRRT treatment,CRRT treatment can prolong survival time,but it is not statistically significant.Conclusion:The mortality of sepsis patients complicated with acute kidney injury is higher in ICU.MAP,SAPS Ⅱ score,APACHE Ⅱ score,and sepsis grading are independent risk factors for patients with sepsis complicated by acute kidney injury,and SAPS Ⅱ is more suitable for the prediction of sepsis patients with AKI than APACHEⅡ score.Age,albumin,serum K+ion concentration,CRP,number of organ failures,MAP,APACHE Ⅱ score,and whether mechanical ventilation are risk factors affecting the prognosis of patients with sepsis complicated by acute kidney injury.CRRT treatment is not statistically significant for prolonging the survival time of patients with sepsis complicated by AKI.Early warning of the above-mentioned related risk factors and effective intervention measures will help to curb the deterioration of the disease and reduce the incidence and mortality of sepsis complicated by AKI.