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The following is a summary of “Epidemiology of sepsis-associated acute kidney injury in the ICU with contemporary consensus definitions,” published in the March 2025 issue of Critical Care by Takeuchi et al. 

Researchers conducted a retrospective study to describe the epidemiology of sepsis-associated acute kidney injury (SA-AKI) using the 2023 updated definition and evaluate clinical outcomes.  

They analyzed data from 2 academic medical centers, including adults admitted to intensive care units (ICU) from 2010 to 2022. Individuals were classified into SA-AKI, sepsis alone, or acute kidney injury (AKI) alone. The SA-AKI was further categorized by onset time as early (<2 days from sepsis diagnosis) or late (2–7 days after sepsis diagnosis) and by the presence of septic shock. Clinical outcomes assessed included hospital mortality and major adverse kidney events (MAKE = death, kidney replacement therapy, or reduced kidney function from baseline) at discharge.  

The results showed that 1,87,888 adult ICU admissions were analyzed, with SA-AKI occurring in nearly half of sepsis cases and 1 in 6 ICU admissions. Among those with SA-AKI, 25% died during hospitalization, and 37.7% had at least 1 MAKE = death, kidney replacement therapy, or reduced kidney function from baseline at discharge. Compared to sepsis or AKI alone, SA-AKI was linked to higher mortality (adjusted hazard ratio [HR] 1.59; 95% CI 1.51–1.66) and increased odds of MAKE (adjusted odds ratio [OR] 3.35; 95% CI 3.19–3.51). The early SA-AKI phenotype was most common, with AKI incidence decreasing daily after sepsis onset. Septic shock significantly worsened outcomes.  

Investigators concluded that SA-AKI, defined by updated consensus criteria, was prevalent in the ICU, associated with high morbidity and mortality and that outcomes varied based on onset timing and shock presence. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-025-05351-5