关键词: 脓毒症, 急性肾损伤, 慢性肾脏病, 危险因素, 肾脏预后

Abstract: Objective To investigate the risk factors of sepsis-induced acute kidney injury (AKI) progressing to
chronic kidney disease (CKD) in critically ill patients. MethodsA total of 134 sepsis patients from intensive care unit of
Shunde Hospital of Guangzhou University of Chinese Medicine were enrolled. According to the 3-month follow-up of renal
function after discharge, the patients were divided into progression to CKD group (CKD, n=40) and non-progression to CKD
group (non-CKD, n =94). The clinical characteristics of patients with sepsis-induced AKI and the risk factors of progressing
to CKD were analyzed. The working characteristic curve (ROC) of subjects was used to evaluate the predictive values of risk
factor for sepsis-induced AKI progressing to CKD. ResultsThere were 40 patients (29.9% of 134 patients) with sepsisinduced AKI progressed into CKD. Compared with non-CKD group, there were a higher SOFA score, blood creatinine,
lactate and higher proportion of mechanical ventilation, renal replacement therapy, AKI ≥ 2 grade, and lower level of eGFR
and serum albumin in CKD group. The high serum levels of creatinine and lactic acid, AKI ≥ 2 and hypoalbuminemia were
independent risk factors for progression of sepsis-induced AKI to CKD. ROC curve showed that the increased serum
creatinine (≥158.7 μmol/L) was important index with higher specificity and sensitivity for predicting the progression of
sepsis-induced AKI to CKD (AUC was 0.875, P＜0.001). ConclusionClose monitoring the related risk factors，such as
serum creatinine, lactate, albumin levels and AKI grading，is conducive to improve the renal prognosis of patients with
septic AKI in ICU.

Key words: sepsis, acute renal injury, chronic kidney disease, risk factors, renal outcome