Skip to main content

Renal Complications in Sepsis Patients: The Importance of Timely Therapy

Sepsis, or the body's extreme response to infection, is a life-threatening medical emergency. Every year, over 30 million people globally are diagnosed with sepsis, with over 5 million of them eventually succumbing to infection.1 In the United States, an estimated 1.7 million adults develop sepsis annually, and 350,000 die.2

The condition occurs when the immune system releases chemicals into the bloodstream to fight an infection, which then triggers a chain reaction of inflammation throughout the body. This means that a sepsis diagnosis can be just the beginning.

The infection can affect organ function and even lead to permanent damage. Those who are critically ill are particularly susceptible to sepsis-related complications, including sepsis-associated acute kidney injury (SA-AKI).

Timely antibiotic treatment (i.e., within the first hour of hypotension or sooner) can improve patients' chances at survival and decrease the incidence of SA-AKI.3

What is Sepsis-associated Acute Kidney Injury?

On its own, acute kidney injury (AKI)—also called acute renal failure—describes sudden and rapid kidney failure or damage. In short, the kidneys are unable to filter out toxins from blood to produce urine due to excessive build-up of waste in the blood stream.4

Sepsis-associated acute kidney injury is a potentially lethal complication of AKI and a common affliction among critically ill patients.5 The rate of sepsis in hospitalized AKI patients as high as 50%.5

What makes SA-AKI dangerous is the fact that it carries a high risk of in-hospital death.5 According to one study, sepsis is the leading cause of death in AKI patients, followed by cardiovascular disease, and malignancy.6

While sepsis is the most common cause of AKI, it should be noted that AKI, in general, is commonly associated with sepsis infection.5

Diagnostics Delays Can Be Deadly

Sepsis and septic shock are associated with high mortality, and one study found that with every hour of delay in antimicrobial intervention, the survival rate drops 7.6%, on average.7 Delayed antibiotic treatment of sepsis in AKI patients, in particular, can result in a 50% higher chance in death if compared to non-sepsis AKI patients.8 And recovery from SA-AKI does not guarantee that the patient will be out of the woods—they still have the risk of developing chronic and permanent kidney disease.5

Preventing SA-AKI can be a challenge for even the most advanced hospitals. The pathophysiology of SA-AKI is not well understood, so specific preventative therapies don't exist.5

Timely antibiotic treatment is therefore crucial to septic patients' survival.7 Effective antibiotic therapy for sepsis can also forestall renal failure—any delay in treatment can be associated with the development of AKI.5

Identifying Sepsis With the Syndromic Approach  

Accurate diagnoses and fast intervention can prove lifesaving for sepsis patients, especially those who may be at risk of developing further complications. However, identifying the cause of sepsis can be tricky in the early stages of infection. The syndromic approach can help eliminate costly guesswork and decrease time to diagnosis, allowing clinicians to determine appropriate treatment for vulnerable patients.

The BIOFIRE® Blood Culture Identification 2 (BCID2) Panel tests a broad menu of possible pathogens with one quick multiplex PCR test. It identifies 43 possible targets, including gram-positive bacteria, gram-negative bacteria, yeast, and 10 antimicrobial resistance genes, and produces results in about an hour from a positive blood culture.

The fast, comprehensive results provided by the first-generation BIOFIRE® FILMARRAY® Blood Culture Identification Panel have been shown to significantly reduce the time to optimal therapy among critically ill patients and among Veterans Affairs care patients.9,10

References

  1. Fleischmann C, et al. Assessment of Global Incidence and Mortality of Hospital-tested Sepsis. Current Estimates and Limitations. Am J Respir Crit Care Med. 2016 Feb 1;193(3):259-72.
  2. What is Sepsis? Accessed 10 January 2023. Retrieved from: https://www.cdc.gov/sepsis/what-is-sepsis.html
  3. Martínez, ML, et al. An approach to antibiotic treatment in patients with sepsis. J Thorac Dis. 2020 Mar;12(3):1007-1021.
  4. Acute Kidney Injury (AKI). Accessed 17 November 2022. Retrieved from: https://www.kidney.org/atoz/content/AcuteKidneyInjury
  5. Peerapornratana S, et al. Acute kidney injury from sepsis: current concepts, epidemiology, pathophysiology, prevention and treatment. Kidney Int. 2019 Nov;96(5):1083-1099.
  6. Selby N, et al. Defining the cause of death in hospitalised patients with acute kidney injury. PLoS One. 2012;7(11):e48580.
  7. Kumar A, et al. Crit Care Med. 2006; 34(6):1589-96.
  8. Setyawati T, Sepsis Associated Acute Kidney Injury. IntechOpen. 2021;doi:10.5772/intechopen.97609
  9. Chiasson J, et al. J Pharm Prac. 2021; 35(5):722-729.
  10. Verroken A., et al. (2019). PLOS ONE: 14(9): e0223122

SHARE THIS ARTICLE:

  • Diagnostic Digest