By the bioMérieux Connection Editors
In a recent interview with Dr. Alexander Flannery, a Critical Care Pharmacist at the University of Kentucky HealthCare, we had the opportunity to discuss his team’s research on sepsis-associated acute kidney disease (AKD)—a term that Dr. Flannery uses to refer to “a non-resolving acute kidney injury (AKI) that lasts at least 7 days but less than 90 days.” His goal is to work toward developing classification systems that could improve risk prediction and prevention.
Sepsis-associated acute kidney injury is a common complication in critically ill patients, is known to increase the risk of developing chronic comorbidities, and is associated with extremely high mortality. Dr. Flannery emphasizes the severity of sepsis as one of the most common contributing factors to AKI in the ICU, accounting for about 50% of occurrences. Recent research has also found that septic patients who developed AKI had twice the duration of ICU stay compared with septic patients without AKI. Both ICU and in-hospital mortality rates were significantly higher for patients with sepsis-associated AKI compared to patients with AKI not associated with sepsis.
In our interview with Dr. Flannery, he remarks that the correlation between sepsis and AKI is due to a range of factors, including the natural course of sepsis as a syndrome and the opportunities for kidney harm. He notes that little is known about sepsis-associated AKI epidemiology, in large part due to the lack of coordinated epidemiological sepsis and AKI criteria among researchers in these areas.
Risk stratification of patients with AKD represents an opportunity to assist with prognostication of long-term kidney complications. Dr. Flannery’s team, “sought to assess how the degree of remaining kidney injury at or shortly after hospital discharge relates to a patient’s risk for long-term kidney outcomes, including new or progressive chronic kidney disease, dialysis, or death. Our results showed that a commonly used classification system for this remaining kidney injury can accurately predict long-term kidney outcomes.” The results of Dr. Flannery’s work may contribute to helping clinicians better identify a patient’s risk for long-term kidney complications after sepsis, and to ensure that they receive the most appropriate attention and care following hospital discharge.
Dr. Flannery feels that more research and coordination is needed to understand the interplay of these diseases states and how to manage it. He says that understanding the relationship between sepsis and kidney disease, “really sets us up to better understand the long-term trajectory of these patients, and we can potentially target better treatments to improve their outcomes.”
Sepsis-Associated Acute Kidney Disease and Long-term Kidney Outcomes
Authors: Alexander H. Flannery, Xilong Li, Natalie L. Delozier, Robert D. Toto, Orson W. Moe, Jerry Yee, and Javier A. Neyra
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