Predictive Role of Hypernatremia for Acute Kidney Injury in Patients with Sepsis

2019 ◽  
Author(s):  
Deyuan Zhi ◽  
Jin Lin ◽  
Lei Dong ◽  
Xiaojun Ji ◽  
Haizhou Zhuang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Predictive Ability ◽  
Organ Damage ◽  
Apache Score ◽  
Septic Acute Kidney Injury ◽  
Increased Risk ◽  
Function Impairment ◽  
Friendship Hospital

Abstract Introduction Septic acute kidney injury (AKI), identified when both sepsis and AKI present, is a syndrome of acute function impairment and organ damage, accounting for ~50% AKI in ICU (Intensive Care Unit)Method This study retrospectively reviewed 591 patients who were diagnosed of sepsis and admitted to the ICU of Beijing Friendship Hospital from January 2009 to December 2014. According to the concentration of serum sodium, the 591 patients were further divided into three groups: normal group, hyponatremia group and hypernatremia group.Result PaCO 2 (P=0.014), concentration of Na + (P<0.001) and Cl - (P<0.001), BUN (P<0.001), APACHE score (P<0.001), SOFA score (P<0.001) and Glasgow score (P<0.001) showed significant differences. CK (P=0.012; OR=1.000), BUN (P=0.002; OR=1.047), Cl - (P<0.001;OR=1.255), lactic acid (P=0.001;OR=1.244), and HCO 3 - (P<0.001;OR=1.180) may be risk factors for hypernatremia in patients with sepsis. APACHE score (P=0.028;OR=1.222) and CK (P=0.014;or=1.003) may be risk factors for AKI in patients with hypernatremia. Na + suggested a good predictive ability for AKI (P<0.001; AUC: 0.586) but not for death (P=0.104)Conclusion Hypernatremia is independently associated with an increased risk and has a predictive ability of AKI in patients with sepsis.

scholarly journals Risk factors and mortality in patients with sepsis, septic and non septic acute kidney injury in ICU

2019 ◽  
Vol 41 (4) ◽  
pp. 462-471 ◽  
Author(s):  
Kellen Hyde Elias Pinheiro ◽  
Franciana Aguiar Azêdo ◽  
Kelsy Catherina Nema Areco ◽  
Sandra Maria Rodrigues Laranja
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Mortality Rates ◽  
Icu Patients ◽  
Septic Acute Kidney Injury ◽  
Observational Cohort ◽  
Worse Prognosis

Abstract Acute kidney injury (AKI) has an incidence rate of 5-6% among intensive care unit (ICU) patients and sepsis is the most frequent etiology. Aims: To assess patients in the ICU that developed AKI, AKI on chronic kidney disease (CKD), and/or sepsis, and identify the risk factors and outcomes of these diseases. Methods: A prospective observational cohort quantitative study that included patients who stayed in the ICU > 48 hours and had not been on dialysis previously was carried out. Results: 302 patients were included and divided into: no sepsis and no AKI (nsnAKI), sepsis alone (S), septic AKI (sAKI), non-septic AKI (nsAKI), septic AKI on CKD (sAKI/CKD), and non-septic AKI on CKD (nsAKI/CKD). It was observed that 94% of the patients developed some degree of AKI. Kidney Disease Improving Global Outcomes (KDIGO) stage 3 was predominant in the septic groups (p = 0.018). Nephrologist follow-up in the non-septic patients was only 23% vs. 54% in the septic groups (p < 0.001). Dialysis was performed in 8% of the non-septic and 37% of the septic groups (p < 0.001). Mechanical ventilation (MV) requirement was higher in the septic groups (p < 0.001). Mortality was 38 and 39% in the sAKI and sAKI/CKD groups vs 16% and 0% in the nsAKI and nsAKI/CKD groups, respectively (p < 0.001). Conclusions: Patients with sAKI and sAKI/CKD had worse prognosis than those with nsAKI and nsAKI/CKD. The nephrologist was not contacted in a large number of AKI cases, except for KDIGO stage 3, which directly influenced mortality rates. The urine output was considerably impaired, ICU stay was longer, use of MV and mortality were higher when kidney injury was combined with sepsis.

scholarly journals The Impact of Anti-Microbial Drug-Drug Interactions on Acute Kidney Injury after Allogeneic Hematopoietic Cell Transplantation

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 29-30
Author(s):  
Fumiya Wada ◽  
Yasuyuki Arai ◽  
Junya Kanda ◽  
Toshio Kitawaki ◽  
Masakatsu Hishizawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Drug Interactions ◽  
Antimicrobial Agents ◽  
Hematopoietic Cell Transplantation ◽  
Kidney Injury ◽  
Time Dependent ◽  
Post Transplant ◽  
Increased Risk ◽  
The Impact

Introduction: Acute kidney injury (AKI) is one of the major complications after allogeneic hematopoietic cell transplantation (allo-HCT), and several studies have demonstrated a relationship between poor outcome and the concomitant AKI in the early phase after allo-HCT. Among various post-transplant factors, usage of antimicrobial agents, especially in cases where multiple agents are combined, may be one of the major causes of post-transplant AKI, due the potential nephrotoxicity of each agent and drug-drug interactions. An association between the combination of vancomycin (VCM) with piperacillin/tazobactam (PIPC/TAZ) and increased risk of developing AKI after allo-HCT has been reported; however, no reports have demonstrated the impact of other combinations on post-transplant AKI. Herein, we performed a retrospective analysis to compare the incidence of AKI according to selected antimicrobial agents, using a database with information covering the time-dependent administrative status of all the agents involved. Methods: We included patients with hematological malignancies who received allo-HCT between 2006 and 2018 in Kyoto University, Kyoto, Japan to evaluate the incidence and risk factors of AKI early after transplantation (before Day100). The incidence of AKI was defined according to Acute Kidney Injury Network (AKIN) classification and evaluated, considering early death as a competing risk. Administrative status of each antimicrobial agent was treated as a time-dependent covariate, and the synergetic effects on AKI by multiple agents in combination were evaluated as p for interaction. Results: In total, 465 transplant cases (416 patients) were included. The median age at HCT was 49 years old (range, 17-70). Among these, 104 cases received a related-donor transplant (64 patients received bone marrow and 40 peripheral-blood stem cell grafts), 207 received a transplant from unrelated donors, and 154 received a single-unit cord-blood transplant. The median value for pre-transplant serum creatinine (sCr) was 0.6 (range, 0.20-1.68). The cumulative incidence of AKI at Day100 was 40.0%, and overall survival (OS) at 3 years after HCT was 43.5% in patients with AKI while 70.9% in those without AKI (hazard ratio [HR] = 2.63, 95% confidence interval = 1.95-3.55, p &lt; 0.01). Being male and having a higher pre-transplant sCr were significant risk factors for AKI (HR = 1.53, p &lt; 0.01 and HR = 4.21, p &lt; 0.01, respectively). After HCT, 34 types of oral or intravenous antimicrobial agents (17 antibiotics, 6 antivirals, and 11 antifungals) were utilized across the entire cohort. A higher incidence of AKI was significantly associated with the use of intravenous ciprofloxacin, foscarnet (FCN), ganciclovir (GCV), liposomal amphotericin B (L-AMB), meropenem (MEPM), PIPC/TAZ, and VCM (p &lt; 0.05). Next, we investigated the synergistic impacts of using anti-pseudomonal antibiotics and anti-methicillin resistant staphylococcus aureus (MRSA) agents, because empiric treatment of febrile neutropenia after HCT often relies on this combination, i.e. CFPM, PIPC/TAZ, or MEPM in combination with VCM or teicoplanin (TEIC). As a result, sole administration of VCM was associated with a higher incidence of AKI; this effect was enhanced when VCM was used in combination with PIPC/TAZ (HR = 3.03, p &lt; 0.01 for VCM without PIPC/TAZ; HR = 4.38, p &lt; 0.01 for VCM with PIPC/TAZ), indicating the existence of interaction between VCM and PIPC/TAZ. However, for the concomitant use of VCM plus CFPM or MEPM, no synergistic interaction was observed with regard to the increased incidence of AKI. In addition, administration of TEIC alone and any combination used with TEIC were not associated with an increased risk of AKI. An increased risk of AKI was also confirmed for the combination of MEPM plus GCV or FCN, and GCV plus L-AMB. Conclusions: AKI was significantly associated with poorer OS, and specific antimicrobial combinations were suggested to increase the risk of AKI. Avoidance of such combinations should be considered to preserve renal function and to reduce AKI-related morbidity and mortality. Disclosures No relevant conflicts of interest to declare.

scholarly journals Early versus late acute kidney injury among patients with COVID-19—a multicenter study from Wuhan, China

2020 ◽  
Vol 35 (12) ◽  
pp. 2095-2102
Author(s):  
Suyuan Peng ◽  
Huai-Yu Wang ◽  
Xiaoyu Sun ◽  
Pengfei Li ◽  
Zhanghui Ye ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Organ Dysfunction ◽  
Clinical Features ◽  
Kidney Injury ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Tertiary Hospitals ◽  
History Of

Abstract Background Acute kidney injury (AKI) is an important complication of coronavirus disease 2019 (COVID-19), which could be caused by both systematic responses from multi-organ dysfunction and direct virus infection. While advanced evidence is needed regarding its clinical features and mechanisms. We aimed to describe two phenotypes of AKI as well as their risk factors and the association with mortality. Methods Consecutive hospitalized patients with COVID-19 in tertiary hospitals in Wuhan, China from 1 January 2020 to 23 March 2020 were included. Patients with AKI were classified as AKI-early and AKI-late according to the sequence of organ dysfunction (kidney as the first dysfunctional organ or not). Demographic and clinical features were compared between two AKI groups. Their risk factors and the associations with in-hospital mortality were analyzed. Results A total of 4020 cases with laboratory-confirmed COVID-19 were included and 285 (7.09%) of them were identified as AKI. Compared with patients with AKI-early, patients with AKI-late had significantly higher levels of systemic inflammatory markers. Both AKIs were associated with an increased risk of in-hospital mortality, with similar fully adjusted hazard ratios of 2.46 [95% confidence interval (CI) 1.35–4.49] for AKI-early and 3.09 (95% CI 2.17–4.40) for AKI-late. Only hypertension was independently associated with the risk of AKI-early. While age, history of chronic kidney disease and the levels of inflammatory biomarkers were associated with the risk of AKI-late. Conclusions AKI among patients with COVID-19 has two clinical phenotypes, which could be due to different mechanisms. Considering the increased risk for mortality for both phenotypes, monitoring for AKI should be emphasized during COVID-19.

Renal outcomes of acute kidney injury

2018 ◽  
Author(s):  
Norbert Lameire
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Subsequent Development ◽  
Complete Recovery ◽  
Epidemiologic Studies ◽  
Screening And Surveillance ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
End Stage

This chapter summarizes the accumulating evidence that incomplete or even apparent complete recovery of renal function after acute kidney injury (AKI) may be an important contributor to a growing number of incident chronic kidney disease (CKD) and end-stage renal disease (ESRD) cases, largely in excess of the global growth in CKD prevalence. Evidence based on epidemiologic studies supports the notion that even after adjustment for several important covariates AKI is independently associated with an increased risk for both CKD and ESRD. Several risk factors for the subsequent development of CKD among survivors of AKI have been identified. Besides well-known risk factors for CKD in general, such as hypertension, older age, congestive heart failure, diabetes, and proteinuria, AKIN staging and duration also predict longitudinal CKD development. These characteristics may identify a category of at-risk AKI patients at the time of hospital discharge that will need long follow-up times for appropriate screening and surveillance measures for CKD.

scholarly journals Risk Factors and Outcomes of Acute Kidney Injury in Neonates with Persistent Pulmonary Hypertension of the Newborn

2021 ◽  
Author(s):  
Nuran Üstün ◽  
Fahri Ovalı
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Pulmonary Hypertension ◽  
Neonatal Intensive Care ◽  
Kidney Injury ◽  
University Hospital ◽  
Persistent Pulmonary Hypertension ◽  
Increased Risk ◽  
Stage 1

Objective: To identify the incidence of and risk factors for acute kidney injury (AKI) in neonates with persistent pulmonary hypertension of the newborn (PPHN) and to evaluate its association with neonatal outcomes. Method: A total of 78 newborns with confirmed PPHN admitted to the neonatal intensive care unit of a university hospital between 2016 and 2020 were retrospectively analyzed. AKI was defined according to the modified neonatal Kidney Disease: Improving Global Outcomes criteria. Results: Of 78 PPHN infants, AKI was found in 29.5% (23/78). Multivariate analysis indicated that male sex (OR 3.43 95% CI 1.03-11.48, p=0.04) and severe PPHN (OR 5.67 95% CI 1.55- 20.68, p<0.01) were independently associated with increased risk for AKI. Infants with AKI had significantly higher mortality rate than infants without AKI (43.5% vs. 9.1%, p<0.01). Mortality rates in stage 1, stage 2 and stage 3 AKI were similar (36.4%, 57.1%, and 40%, respectively, p=0.68). Among survivors, AKI infants had significantly longer mechanical ventilation and lenght of stay than infants without AKI. Conclusion: In infants with PPHN, AKI is a common complication and is associated with increased mortality, and longer mechanical ventilation and lenght of stay. Careful monitoring of kidney function in infants with PPHN, especially in males and those who had severe PPHN can help to improve patient outcomes.

scholarly journals Risk Factors for Acute Kidney Injury in Critically Ill Neonates: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Qian Hu ◽  
Shao-Jun Li ◽  
Qian-Ling Chen ◽  
Han Chen ◽  
Qiu Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Acute Kidney Injury ◽  
Critically Ill ◽  
Apgar Score ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Cochrane Library ◽  
Increased Risk ◽  
Critically Ill Neonates

Background and Objective: Acute kidney injury (AKI) is recognized as an independent risk factor for mortality and long-term poor prognosis in neonates. The objective of the study was to identify the risk factors for AKI in critically ill neonates to provide an important basis for follow-up research studies and early prevention.Methods: The PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WanFang Med, SinoMed, and VIP Data were searched for studies of risk factors in critically ill neonates. Studies published from the initiation of the database to November 19, 2020, were included. The quality of studies was assessed by the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality (AHRQ) checklist. The meta-analysis was conducted with Stata 15 and drafted according to the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement.Results: Seventeen studies (five cohort studies, ten case-control studies, and two cross-sectional studies) were included in meta-analysis, with 1,627 cases in the case group and 5,220 cases in the control group. The incidence of AKI fluctuated from 8.4 to 63.3%. Fifteen risk factors were included, nine of which were significantly associated with an increased risk of AKI in critically ill neonates: gestational age [standardized mean difference (SMD) = −0.31, 95%CI = (−0.51, −0.12), P = 0.002], birthweight [SMD = −0.37, 95%CI = (−0.67, −0.07), P = 0.015], 1-min Apgar score [SMD = −0.61, 95%CI = (−0.78, −0.43), P = 0.000], 5-min Apgar score [SMD = −0.71, 95%CI = (−1.00, −0.41), P = 0.000], congenital heart disease (CHD) [odds ratio (OR) = 2.94, 95%CI = (2.08, 4.15), P = 0.000], hyperbilirubinemia [OR = 2.26, 95%CI = (1.40, 3.65), P = 0.001], necrotizing enterocolitis (NEC) [OR = 6.32, 95%CI = (2.98, 13.42), P = 0.000], sepsis [OR = 2.21, 95%CI = (1.25, 3.89), P = 0.006], and mechanical ventilation [OR = 2.37, 95%CI = (1.50, 3.75), P = 0.000]. Six of them were not significantly associated with AKI in critically ill neonates: age [SMD = −0.25, 95%CI = (−0.54, 0.04), P = 0.095], male sex [OR = 1.10, 95%CI =(0.97, 1.24), P = 0.147], prematurity [OR = 0.90, 95%CI(0.52, 1.56), P = 0.716], cesarean section [OR = 1.52, 95%CI(0.77, 3.01), P = 0.234], prenatal hemorrhage [OR = 1.41, 95%CI = (0.86, 2.33), P = 0.171], and vancomycin [OR = 1.16, 95%CI = (0.71, 1.89), P = 0.555].Conclusions: This meta-analysis provides a preliminary exploration of risk factors in critically ill neonatal AKI, which may be useful for the prediction of AKI.Systematic Review Registration: PROSPERO (CRD42020188032).

scholarly journals Evaluation of the Risk Factors for Acute Kidney Injury in Neonates Exposed to Antenatal Indomethacin

2020 ◽  
Vol 25 (7) ◽  
pp. 606-616
Author(s):  
Jennifer T. Pham ◽  
Jessica L. Jacobson ◽  
Kirsten H. Ohler ◽  
Donna M. Kraus ◽  
Gregory S. Calip
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Patent Ductus Arteriosus ◽  
Bloodstream Infection ◽  
Proportional Hazards ◽  
Ductus Arteriosus ◽  
Kidney Injury ◽  
Cox Proportional Hazards ◽  
Increased Risk ◽  
Patent Ductus

OBJECTIVE Evidence is limited about important maternal and neonatal risk factors that affect neonatal renal function. The incidence of acute kidney injury (AKI) and identification of associated risk factors in neonates exposed to antenatal indomethacin was studied. METHODS A retrospective cohort of neonates exposed to antenatal indomethacin within 1 week of delivery was analyzed for development of AKI up to 15 days of life. Adjusted hazard ratios (HRs) and 95% CIs for AKI risk were calculated in time-dependent Cox proportional hazards models. RESULTS Among 143 neonates with mean gestational age of 28.3 ± 2.4 weeks, AKI occurred in 62 (43.3%), lasting a median duration of 144 hours (IQR, 72–216 hours). Neonates with AKI had greater exposure to postnatal NSAIDs (48.4% vs 9.9%, p &lt; 0.001) and inotropes (37.1% vs 3.7%, p &lt; 0.001) compared with neonates without AKI. In multivariable-adjusted models, increased AKI risk was observed with antenatal indomethacin doses received within 24 to 48 hours (HR, 1.6; 95% CI, 1.28–1.94; p = 0.036) and &lt;24 hours (HR, 2.33; 95% CI, 1.17–4.64; p = 0.016) prior to delivery. Further, postnatal NSAIDs (HR, 2.8; 95% CI, 1.03–7.61; p = 0.044), patent ductus arteriosus (HR, 4.04; 95% CI, 1.27–12.89; p = 0.018), and bloodstream infection (HR, 3.01; 95% CI, 1.37–6.60; p = 0.006) were associated significantly with increased risk of AKI following antenatal indomethacin. Neonates with AKI experienced more bloodstream infection, severe intraventricular hemorrhage, patent ductus arteriosus, respiratory distress syndrome, and longer hospitalization. CONCLUSIONS Extended risk of AKI with antenatal indomethacin deserves clinical attention among this population at an already increased AKI risk.

scholarly journals Incidence of Contrast Induced Acute Kidney Injury, Its Risk Factors and In-Hospital Outcomes in Patients Undergoing Coronary Angiography and Angioplasty

2020 ◽  
Vol 42 (2) ◽  
pp. 59-63
Author(s):  
Prashun Upadhaya ◽  
Pradeep Thapa ◽  
Ratna M Gajurel ◽  
Mahesh R Sigdel
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Statistical Analysis ◽  
Coronary Angiography ◽  
Logistic Regression Analysis ◽  
Kidney Injury ◽  
Increased Risk ◽  
Contrast Exposure

Introduction Contrast-induced acute kidney injury (CI-AKI) is a serious complication of angiographic procedures with significant morbidity and mortality. We aimed to find the incidence, risk factors and outcomes of CI-AKI in patients who have undergone coronary angiography/angioplasty in a referral hospital in Nepal. MethodsIt was a descriptive observational study of consenting consecutive patients above 18 years undergoing coronary angiography/angioplasty at Manmohan Cardiothoracic Vascular and Transplant Centre, Nepal from July 2015 to September 2017. CI AKI was defined as an elevation of serum creatinine of >25% or ≥0.5 mg/dl (44 μmol/L) from baseline within 48 hour of exposure to contrast. Statistical analysis was performed using SPSS 18 software. Statistical analysis was completed using Student’s t-test, chi-square test and multivariable logistic regression analysis. ResultsOut of 240 patients, 156 (65%) were male, mean age was 60.36±11.29 years. Eighteen patients (7.5%) developed CI-AKI. Incidence of CI-AKI was 20% in patients with chronic kidney disease (CKD), 5.4% in diabetics, 13.6% in patients >70 years, 12.79 % in patients with anaemia and 12.3% in patients with prior contrast exposure. Multivariate logistic regression analysis found smoking and history of prior contrast exposure to be independent predictors for development of CI-AKI. Among patients with CI-AKI, one (5.88%) required dialysis and one (5.88%) died. ConclusionIncidence of CI-AKI after coronary angiography/angioplasty was 7.5%. Patients with prior contrast exposure and smoking were at significantly increased risk of CI-AKI; higher trend of CI-AKI was seen in patients with CKD, diabetes, elderly and anaemia.

scholarly journals PREDICTORS IN-HOSPITAL MORTALITY OF SEPTIC VS NON-SEPTIC ACUTE KIDNEY INJURY PATIENTS: AN OBSERVATIONAL COHORT STUDY

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1184
Author(s):  
Nur Samsu ◽  
Mochammad Jalalul Marzuki ◽  
Irma Chandra Pratiwi ◽  
Ratna Adelia Pravitasari ◽  
Achmad Rifai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Tertiary Hospital ◽  
Renal Recovery ◽  
Predictors Of Mortality ◽  
Septic Acute Kidney Injury ◽  
Observational Cohort

Background: To compare the predictors In-hospital mortality of patients with septic Acute Kidney Injury (S-AKI) and non-septic AKI (NS-AKI). Methods: a cohort study of critically ill patients with AKI admitted to the emergency room at a tertiary hospital from January to June 2019. The primary outcome was hospital mortality. Results: There were 116 patients who met the inclusion criteria. Compared with NS-AKI, patients with S-AKI had significantly lower mean MAP, median eGFR, and urine output. (UO). S-AKI had higher mortality and vasopressor requirements and had a lower renal recovery than NS-AKI (63.2% vs 31.4%, p=0.001; 30.8% vs 13.7%, p=0.031, and 36.9% vs 60.8%, p=0.011, respectively). AKI stage 3 and vasopressor requirements were dependent risk factors for both S-AKI and NS-AKI mortality. Meanwhile, SOFA score > 7 and the need for dialysis are dependent and independent risk factors for mortality in S-AKI. Worsening and/or persistence in UO, serum urea and creatinine levels at 48 h after admission were predictors of mortality in S-AKI and NS-AKI. Improvement in UO in surviving patients was more pronounced in S-AKI than in NS-AKI (50% vs 17.1%, p=0.007). The surviving S-AKI patients had a longer hospital stay than surviving NS-AKI [8 (6-14.5) vs 5 (4 – 8), p=0.004]. S-AKI have higher mortality and vasopressor requirements and have lower renal recovery than NS-AKI. Conclusion: S-AKI have higher mortality and vasopressor requirements and a lower renal recovery than NS-AKI. Independent predictors of mortality in S-AKI were high SOFA scores and the need for dialysis.

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