Two subphenotypes of septic acute kidney injury are associated with different 90-day mortality and renal recovery

Abstract Background The pathophysiology of septic acute kidney injury is inadequately understood. Recently, subphenotypes for sepsis and AKI have been derived. The objective of this study was to assess whether a combination of comorbidities, baseline clinical data, and biomarkers could classify meaningful subphenotypes in septic AKI with different outcomes. Methods We performed a post hoc analysis of the prospective Finnish Acute Kidney Injury (FINNAKI) study cohort. We included patients admitted with sepsis and acute kidney injury during the first 48 h from admission to intensive care (according to Kidney Disease Improving Global Outcome criteria). Primary outcomes were 90-day mortality and renal recovery on day 5. We performed latent class analysis using 30 variables obtained on admission to classify subphenotypes. Second, we used logistic regression to assess the association of derived subphenotypes with 90-day mortality and renal recovery on day 5. Results In total, 301 patients with septic acute kidney injury were included. Based on the latent class analysis, a two-class model was chosen. Subphenotype 1 was assigned to 133 patients (44%) and subphenotype 2 to 168 patients (56%). Increased levels of inflammatory and endothelial injury markers characterized subphenotype 2. At 90 days, 29% of patients in subphenotype 1 and 41% of patients in subphenotype 2 had died. Subphenotype 2 was associated with a lower probability of short-term renal recovery and increased 90-day mortality. Conclusions In this post hoc analysis, we identified two subphenotypes of septic acute kidney injury with different clinical outcomes. Future studies are warranted to validate the suggested subphenotypes of septic acute kidney injury.

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PID https://www.doi.org/10.6084/m9.figshare.c.4939893
PID https://www.doi.org/10.6084/m9.figshare.c.4939893.v1
URL http://dx.doi.org/10.6084/m9.figshare.c.4939893
URL http://hdl.handle.net/10138/314185
URL http://dx.doi.org/10.6084/m9.figshare.c.4939893.v1
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Author Wiersema, Renske
Author Jukarainen, Sakari
Author Vaara, Suvi T.
Author Poukkanen, Meri
Author Lakkisto, Päivi
Author Wong, Hector
Author Linder, Adam
Author Horst, Iwan C. C. Van Der
Author Pettilä, Ville
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Collected From HELDA - Digital Repository of the University of Helsinki; Datacite
Hosted By HELDA - Digital Repository of the University of Helsinki; figshare
Publication Date 2020-04-15
Publisher figshare
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Country Finland
Language UNKNOWN
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system:type other
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Source https://science-innovation-policy.openaire.eu/search/other?orpId=dedup_wf_001::01f0f3bfc36c81f8ca125dfc395fc3c0
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Last Updated 19 December 2020, 23:29 (CET)
Created 19 December 2020, 23:29 (CET)