Protein-Energy Wasting Assessment and Clinical Outcomes in Patients with Acute Kidney Injury: A Systematic Review with Meta-Analysis

Nutritional assessment is essential to identify patients with acute kidney injury (AKI) who are protein-energy wasting (PEW) and at risk of poor clinical outcomes. This systematic review aimed to investigate the relationship of nutritional assessments for PEW with clinical outcomes in patients with AKI. A systematic search was performed in PubMed, Scopus, and Cochrane Library databases using search terms related to PEW, nutrition assessment, and AKI to identify prospective cohort studies that involved AKI adult patients with at least one nutritional assessment performed and reported relevant clinical outcomes, such as mortality, length of stay, and renal outcomes associated with the nutritional parameters. Seventeen studies reporting eight nutritional parameters for PEW assessment were identified and mortality was the main clinical outcome reported. A meta-analysis showed that PEW assessed using subjective global assessment (SGA) was associated with greater mortality risk (RR: 1.99, 95% CI: 1.36–2.91). Individual nutrition parameters, such as serum chemistry, body mass, muscle mass, and dietary intakes, were not consistently associated with mortality. In conclusion, SGA is a valid tool for PEW assessment in patients with AKI, while other nutrition parameters in isolation had limited validity for PEW assessment.

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Rates, predictors and mortality of sepsis-associated acute kidney injury: systematic review and meta-analysis

10.21203/rs.3.rs-18145/v3 ◽

2020 ◽

Author(s):

Jie feng Liu ◽

Hebin Xie ◽

ziwei ye ◽

Lesan Wang

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Septic Shock ◽

Acute Kidney Injury ◽

Meta Analysis ◽

Kidney Injury ◽

Predisposing Factors ◽

Cochrane Library ◽

Patient Specific ◽

Cumulative Number

Abstract Objective:The incidence and mortality of sepsis-induced acute kidney injury is high. Many studies have explored the causes of sepsis-induced acute kidney injury (AKI). However, its predictors are still uncertain; additionally, a complete overview is missing. A systematic review and a meta-analysis were performed to determine the predisposing factors for sepsis-induced AKI. Method: A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed and Web of Science databases, with an end date parameter of May 25, 2019. Valid data were retrieved in compliance with the inclusion and exclusion criteria. Result: Forty-seven observational studies were included for analysis. A cumulative number of 55911sepsis patients were evaluated. The incidence of AKI caused by septic shock is the highest. 30 possible risk factors were included in the meta-analysis. The results showed that 20 factors were found to be significant. The odds ratio(OR),95% confidence interval (CI) and Prevalence of the most prevalent predisposing factors for sepsis-induced AKI were as the following: Septic shock[2.88(2.36-3.52), 60.47%], Hypertension[1.43(1.20-1.70),38.39%), Diabetes mellitus[1.59(1.47-1.71),27.57%],Abdominal infection[1.44(1.32-1.58),30.87%], Vasopressors use[2.95(1.67-5.22),64.61%],vasoactive drugs use [3.85(1.89-7.87),63.22%], Mechanical ventilation[1.64(1.24-2.16),68.00%), Positive blood culture[1.60(1.35-1.89), 41.19%], Smoke history[1.60(1.09-2.36),43.09%]. Other risk factors include cardiovascular, coronary artery disease, liver disease, unknow infection, diuretics use, ACEI or ARB, gram-negative bacteria and organ transplant. Conclusion: A large number of factors are associated with AKI development in sepsis patients. Our review can guide risk-reducing interventions, clinical prediction rules, and patient-specific treatment and management strategies for sepsis-induced acute kidney injury.

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Prevalence of acute kidney injury after cardiac surgery:A systematic review and meta-analysis on risk factors and different diagnostic criterias(AKIN,RIFLE,KDIGO)

10.21203/rs.2.17474/v1 ◽

2019 ◽

Author(s):

Alii Alidadii ◽

Morteza Salarzaei ◽

Fatem Parooe

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Acute Kidney Injury ◽

Cardiac Surgery ◽

Meta Analysis ◽

Kidney Injury ◽

World Health ◽

Cochrane Library ◽

Common Symptom ◽

Total Prevalence

Abstract Objective: This systematic review and meta-analysis aimed to determine the incidence and some of risk factors of AKI after cardiac surgery using all three diagnostic criteria (AKIN,RIFLE, and KIDGO).Method: We searched for published literature in the English language in MEDLINE via PubMed, EMBASETM via Ovid, The Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID) , KoreaMed and LILACS, and we searched OpenGrey (www.opengrey.eu/) and the World Health Organization Clinical Trials Registry (who.int/ictrp) for unpublished literature and ongoing studies.To ensure the literature saturation, the list of the included research references or the relevant reviews found by searching was studied(MS). The keywords used in the search strategy were Acute kidney injury,acute renal failure, creatinine,cardiac surgery,heart surgury, Coronary artery bypass grafting(CABG),valve replacement,RIFLE (risk, injury, failure, loss, end-stage renal disease) ,Acute Kidney Injury Network (AKIN),KDIGO (Kidney Disease: Improving Global Outcomes) , which were combined using the AND, OR, and NOT operators.Results: A total of 33298 patients who had undergone the cardiac surgery were studied. Based on the random effect model the total prevalence of AKI in 33298 patients undergone the heart surgery was 26.3% (95% confidence interval[CI]:26.1%,26.6%, I2=99.5%). the total prevalence of AKI in patients undergone cardiac surgery based on AKIN criteria was 21.6% (95% CI –21.2%, 22.1%,I2=98.5%) of whom 21.6% (95% CI-21.2%,22.1%,I2=98.5%) were classified as AKIN stage 1, whereas 3% (95% CI-2.7%%,3.4%%,I2=90.6%) were classified as AKIN stage 2, and 3.2% (95% CI-3.0%%,3.4%%,I2=97.2%) were classified as AKIN stage 3. the total prevalence of AKI in patients undergone cardiac surgery based on RIFLE criteria was 26.0%% (95% CI –25.6%, 26.5%,I2=99.4%). total prevalence of AKI in patients undergone cardiac surgery based on KDIGO criteria was 34.7% (95% CI –33.8%, 35.7%,I2=98.4%). the highest prevalence of AKI in patients undergone cardiac surgery was in Brazil 45.7% (95% CI –43.6%, 47.8%) based on 3 articles included followed by USA with a prevalence of 29.6%(95% CI –28.7%, 29.4%) based on 7 articles included, Uruguay with a prevalence of 36.1%(95% CI –35%, 37.2%) based on 1 article, Canada with a prevalence of 16.7%(95% CI –15.7%, 17.6%) based on 4 articles included and Italy with a prevalence of 10.6%(95% CI –9.8%, 11.3%) based on 3 articles included.Conclusion: AKI after cardiac surgery is a common symptom, although most often more severe in elderly patients. The prevalence of AKI after cardiac surgery based on KDIGO criteria was found to be higher than RIFLE and AKIN. The prevalence of AKI regardless of the definition used showed a decreasing trend from 2009 to 2019. Our findings pointed to the superiority of the KDIGO criterion over RIFLE and AKIN for diagnosing and evaluating AKI after cardiac surgery. However, the widespread acceptance of consensus definitions ( RIFLE and AKIN criteria) for AKI is still reflected in the studies. In order to progress further, establishment of a uniform definition for AKI seems necessary.

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SO017EFFECT OF HIGH-CUTOFF DIALYSIS FOR ACUTE KIDNEY INJURY SECONDARY TO CAST NEPHROPATHY IN PATIENTS WITH MULTIPLE MYELOMA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa139.so017 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Blanca Tarragon ◽

Nan Ye ◽

Martin Gallagher ◽

Shaundeep Sen ◽

Jose' M Portoles ◽

...

Keyword(s):

Systematic Review ◽

Multiple Myeloma ◽

Acute Kidney Injury ◽

Clinical Outcomes ◽

Observational Studies ◽

Meta Analysis ◽

Kidney Injury ◽

Controlled Trials ◽

Cast Nephropathy ◽

All Cause Mortality

Abstract Background and Aims The incidence of multiple myeloma (MM) is increasing. Abnormal secretion of serum free light chains (sFLC) can lead to cast nephropathy and severe acute kidney injury (AKI) requiring haemodialysis (HD), which is associated with increased morbidity and mortality. High cut-off (HCO) HD membranes demonstrate better sFLC clearance. However, their role in all-cause mortality and renal recovery remains uncertain. Method A systematic review and meta-analysis was performed examining all randomized controlled trials (RCTs) and observational studies assessing the effect of high cut-off HD compared to conventional HD on clinical outcomes of patients with MM complicated by cast nephropathy induced-severe AKI. Medline, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until September 2019. The primary outcome was all-cause mortality at the end of the study. The secondary outcomes included all-cause mortality at 12 months, haemodialysis independence at 3, 6 and 12 months, biopsy-proven haematologic responses at 90 days and sFLC (kappa and lambda) reduction. Random effect models were used to pool relative risks (RR) with 95% conﬁdence intervals (CIs) for individual studies. Results The search identified 5 studies including 276 patients with a mean follow-up of 18.7 months. There were 2 RCTs and 3 retrospective cohort studies. Compared with patients treated with conventional HD, patients on HCO dialysis did not show survival benefits at 12 months (4 studies, 186 patients, RR 0.79; 95% CI 0.46-1.36), or at the end of the study (5 studies, 276 patients, RR 0.86; 95% CI 0.60-1.25). Although survival benefits at the end of study (3 studies, 88 patients, RR 0.64; 95% CI 0.45-0.90) were seen in observational studies, no differences in all-cause mortality was seen in RCTs (2 studies, 188 patients, RR 1.31; 95% CI 0.50-3.46). Likewise, although the pooled data from the observational studies demonstrated significantly higher rates of HD independence at 90 days (2 trials, 78 patients, RR 2.23; 95% CI 1.09-4.55), this difference disappeared when the data from RCTs were included to the analysis (4 studies, 266 patients, RR 1.28; 95% CI 0.95-1.73). There was no difference in HD Independence at 6 months (2 studies, 188 patients, RR 1.19; 95% CI 0.68-2.06), and 12 months (2 studies, 188 patients, RR 1.14; 95% CI 0.58-2.26) between these two therapies. Patients receiving HCO dialysis, however, had significantly better biopsy-proven haematologic response at 90 days by 40% (3 studies, 176 patients, RR 1,40; 95% CI 1.13-1.74) and a significantly higher kappa light chain reduction (2 studies, 188 patients, standardized mean difference (SMD) 2.37; 95% CI 1.99-2.75; I2 = 0%). Overall, the majority of the studies were of suboptimal quality and underpowered. Conclusion Current evidence from RCTs and observational studies suggest HCO dialysis provides haematological benefits but makes no significant improvement in all-cause mortality and renal outcomes, compared to conventional HD for patients with multiple myeloma associated cast nephropathy. However, there is a trend towards better renal outcomes, therefore further large-scale RCTs are needed to assess the effect of HCO dialysis on clinical outcomes in patients with multiple myeloma complicated by cast-nephropathy.

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

Frontiers in Pediatrics ◽

10.3389/fped.2021.666507 ◽

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).

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Rates, predictors and mortality of sepsis-induced acute kidney injury: systematic review and meta-analysis

10.21203/rs.3.rs-18145/v2 ◽

2020 ◽

Author(s):

Jie feng Liu ◽

Hebin Xie ◽

ziwei ye ◽

Lesan Wang

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Septic Shock ◽

Acute Kidney Injury ◽

Meta Analysis ◽

Kidney Injury ◽

Predisposing Factors ◽

Cochrane Library ◽

Patient Specific ◽

Cumulative Number

Abstract Objective The incidence and mortality of sepsis-induced acute kidney injury is high. Many studies have explored the causes of sepsis-induced acute kidney injury (AKI). However, its predictors are still uncertain; additionally, a complete overview is missing. A systematic review and a meta-analysis were performed to determine the predisposing factors for sepsis-induced AKI. Method A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed and Web of Science databases, with an end date parameter of May 25, 2019. Valid data were retrieved in compliance with the inclusion and exclusion criteria. Result Forty-seven observational studies were included for analysis. A cumulative number of 55911sepsis patients were evaluated. The incidence of AKI caused by septic shock is the highest. 30 possible risk factors were included in the meta-analysis. The results showed that 20 factors were found to be significant. The odds ratio(OR),95% confidence interval (CI) and Prevalence of the most prevalent predisposing factors for sepsis-induced AKI were as the following: Septic shock[2.88(2.36-3.52), 60.47%], Hypertension[1.43(1.20-1.70),38.39%), Diabetes mellitus[1.59(1.47-1.71),27.57%],Abdominal infection[1.44(1.32-1.58),30.87%], Vasopressors use[2.95(1.67-5.22),64.61%],vasoactive drugs use [3.85(1.89-7.87),63.22%], Mechanical ventilation[1.64(1.24-2.16),68.00%), Positive blood culture[1.60(1.35-1.89), 41.19%], Smoke history[1.60(1.09-2.36),43.09%]. Other risk factors include cardiovascular, coronary artery disease, liver disease, unknow infection, diuretics use, ACEI or ARB, gram-negative bacteria and organ transplant. Conclusion A large number of factors are associated with AKI development in sepsis patients. Our review can guide risk-reducing interventions, clinical prediction rules, and patient-specific treatment and management strategies for sepsis-induced acute kidney injury.

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Predictive Value of Hypoalbuminemia for Contrast-Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis

Angiology ◽

10.1177/0003319721989185 ◽

2021 ◽

pp. 000331972198918

Author(s):

Liwei Liu ◽

Zhubin Lun ◽

Bo Wang ◽

Li Lei ◽

Guoli Sun ◽

...

Keyword(s):

Systematic Review ◽

Acute Kidney Injury ◽

Predictive Value ◽

Fixed Effects ◽

Meta Analysis ◽

Kidney Injury ◽

Clinical Intervention ◽

Cochrane Library ◽

Fixed Effects Model ◽

Increased Risk

Contrast-associated acute kidney injury (CA-AKI) is a major adverse complication of intravascular administration of contrast medium. Current studies have shown that hypoalbuminemia might be a novel risk factor of CA-AKI. This systematic review and meta-analysis was performed to evaluate the predictive value of hypoalbuminemia for CA-AKI. Relevant studies were identified in Ovid-Medline, PubMed, Embase, and Cochrane Library up to December 31, 2019. Two authors independently screened studies, consulting with a third author when necessary to resolve discrepancies. The pooled odds ratio (OR) was calculated to assess the association between hypoalbuminemia and CA-AKI using a random-effects model or fixed-effects model. Eight relevant studies involving a total of 18 687 patients met our inclusion criteria. The presence of hypoalbuminemia was associated with an increased risk of CA-AKI development (pooled OR: 2.59, 95% CI: 1.80-3.73). Hypoalbuminemia is independently associated with the occurrence of CA-AKI and may be a potentially modifiable factor for clinical intervention. This systematic review and meta-analysis was registered in PROSPERO (CRD42020168104).

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Intermittent Convective Therapies in Patients with Acute Kidney Injury: A Systematic Review with Meta-Analysis

Blood Purification ◽

10.1159/000515641 ◽

2021 ◽

pp. 1-12

Author(s):

Jean Maxime Côté ◽

Louis Pinard ◽

Jean-Francois Cailhier ◽

Renée Lévesque ◽

Patrick T. Murray ◽

...

Keyword(s):

Systematic Review ◽

Acute Kidney Injury ◽

Observational Studies ◽

Meta Analysis ◽

Kidney Injury ◽

Renal Recovery ◽

Cochrane Library ◽

Significant Difference ◽

Short Term Mortality ◽

Circuit Loss

Introduction: In critically ill patients requiring intermittent renal replacement therapy (RRT), the benefits of convective versus diffusive clearance remain uncertain. We conducted a systematic review and meta-analysis to determine the safety, clinical efficacy, and clearance efficiency of hemofiltration (HF) and hemodiafiltration (HDF) compared to hemodialysis (HD) in patients with acute kidney injury (AKI) receiving intermittent RRT. Method: We searched Medline, Embase, Cochrane Library, and PROSPERO. We included clinical trials and observational studies that reported the use of intermittent HF or HDF in adult patients with AKI. The following outcomes were included: mortality, renal recovery, clearance efficacy, intradialytic hemodynamic stability, circuit loss, and inflammation modulation. Results: A total of 3,169 studies were retrieved and screened. Four randomized controlled trials and 4 observational studies were included (n: 615 patients). Compared with conventional HD, intermittent convective therapies had no effect on in-hospital mortality (relative risk, 1.23; 95% confidence interval (CI), 0.76–1.99), renal recovery at 30 days (RR, 0.98; 95% CI, 0.82–1.16), time-to-renal recovery (mean difference [MD], 0.77; 95% CI, −6.56 to 8.10), and number of dialysis sessions until renal recovery (MD, −1.34; 95% CI, −3.39 to 0.72). The overall quality of included studies was low, and dialysis parameters were suboptimal for all included studies. Conclusion: This meta-analysis suggests that there is no significant difference in short-term mortality and renal recovery in patients with severe AKI when treated with intermittent HF or HDF compared to conventional HD. This systematic review emphasizes the need for further trials evaluating optimal convective parameters in AKI patients treated with intermittent dialysis.

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Rates, predictors and mortality of sepsis-induced acute kidney injury: systematic review and meta-analysis

10.21203/rs.3.rs-18145/v4 ◽

2020 ◽

Author(s):

Jie feng Liu ◽

Hebin Xie ◽

ziwei ye ◽

Fen Li ◽

Lesan Wang

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Septic Shock ◽

Acute Kidney Injury ◽

Meta Analysis ◽

Kidney Injury ◽

Predisposing Factors ◽

Cochrane Library ◽

Patient Specific ◽

Wide Range

Abstract Background: Due to the high incidence and mortality of sepsis-associated acute kidney injury, a significant number of studies have explored the causes of sepsis-associated acute kidney injury (AKI). However, the opinions on relevant predictive risk factors remain inconclusive. This study aimed to provide a systematic review and a meta-analysis to determine the predisposing factors for sepsis-associated AKI.Method: A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed, and Web of Science, databases, with an end-date of 25th May 2019. Valid data were retrieved in compliance with specific inclusion and exclusion criteria.Result: Forty-seven observational studies were included for analysis, achieving a cumulative patient number of 55,911. The highest incidence of AKI was caused by septic shock. Thirty-one potential risk factors were included in the meta-analysis. Analysis showed that 20 factors were statistically significant. The odds ratio (OR) and 95% confidence interval (CI), as well as the prevalence of the most frequently-seen predisposing factors for sepsis-associated AKI, were as follows: septic shock [2.88 (2.36-3.52), 60.47%], hypertension [1.43 (1.20-1.70), 38.39%], diabetes mellitus [1.59 (1.47-1.71), 27.57%], abdominal infection [1.44 (1.32-1.58), 30.87%], the administration of vasopressors [2.95 (1.67-5.22), 64.61%], the administration of vasoactive drugs [3.85 (1.89-7.87), 63.22%], mechanical ventilation [1.64 (1.24-2.16), 68.00%], positive results from blood culture [1.60 (1.35-1.89), 41.19%], and a history of smoking [1.60 (1.09-2.36), 43.09%]. Other risk factors included cardiovascular diseases, coronary artery diseases, liver diseases, unknown infections, the administration of diuretics and ACEI/ARB, infection caused by gram-negative bacteria, and organ transplantation.Conclusion: Risk factors of S-AKI arise from a wide range of sources, making it difficult to predict and prevent this condition. Comorbidities, and certain drugs, are the main risk factors for S-AKI. Our review can provide guidance on the application of interventions to reduce the risks associated with sepsis-associated acute kidney injury and can also be used to tailor patient-specific treatment plans and management strategies in clinical practice.

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Rates, predictors and mortality of sepsis-induced acute kidney injury: systematic review and meta-analysis

10.21203/rs.3.rs-18145/v1 ◽

2020 ◽

Author(s):

Jie feng Liu ◽

Hebin Xie ◽

Ziwei Ye ◽

Lesan Wang

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Septic Shock ◽

Acute Kidney Injury ◽

Meta Analysis ◽

Kidney Injury ◽

Predisposing Factors ◽

Cochrane Library ◽

Patient Specific ◽

Cumulative Number

Abstract Background The incidence and mortality of sepsis-induced acute kidney injury is high. Many studies have explored the causes of sepsis-induced acute kidney injury (AKI). However, its predictors are still uncertain; additionally, a complete overview is missing. A systematic review and a meta-analysis were performed to determine the predisposing factors for sepsis-induced AKI.Method A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed and Web of Science databases, with an end date parameter of May 25, 2019. Valid data were retrieved in compliance with the inclusion and exclusion criteria.Result Forty-seven observational studies were included for analysis. A cumulative number of 55911sepsis patients were evaluated. The incidence of AKI caused by septic shock is the highest. 30 possible risk factors were included in the meta-analysis. The results showed that 20 factors were found to be significant. The odds ratio(OR),95% confidence interval (CI) and Prevalence of the most prevalent predisposing factors for sepsis-induced AKI were as the following: Septic shock[2.88(2.36-3.52), 60.47%], Hypertension[1.43(1.20-1.70),38.39%), Diabetes mellitus[1.59(1.47-1.71),27.57%],Abdominal infection[1.44(1.32-1.58),30.87%], Vasopressors use[2.95(1.67-5.22),64.61%],vasoactive drugs use [3.85(1.89-7.87),63.22%], Mechanical ventilation[1.64(1.24-2.16),68.00%), Positive blood culture[1.60(1.35-1.89), 41.19%], Smoke history[1.60(1.09-2.36),43.09%]. Other risk factors include cardiovascular, coronary artery disease, liver disease, unknow infection, diuretics use, ACEI or ARB, gram-negative bacteria and organ transplant.Conclusion A large number of factors are associated with AKI development in sepsis patients. Our review can guide risk-reducing interventions, clinical prediction rules, and patient-specific treatment and management strategies for sepsis-induced acute kidney injury.

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