Risk of de novo infection following acute kidney injury: A retrospective cohort study

Purpose: Recent studies suggest that acute kidney injury (MU) can affect distant organ function and increase nonrenal complications. We determined whether AKI is associated with an increased risk of incident infections. Material and methods: We conducted a one-year single-center retrospective cohort study, excluding patients readmitted to the ICU or for <24 h, on chronic dialysis, and kidney transplant recipients. The primary outcome was the development of incident infections analyzed by multivariate time-dependent Cox models. Results: Of the 1001 included patients, infections were more frequent in those with AKI (62% vs. 37% without AKI: p < .001). To characterize predictors of incident infections, we excluded patients with an infection until ICU admission (n = 244). Patients with AKI presented infections more often than without AKI (44% vs. 20%; p < .001). AKI, chronic obstructive pulmonary disease, and mechanical ventilation (MV) were associated with incident infections (HR 1.62,95%CI:1.15-2.30, HR 1.51, 95%CI 1.04-2.18 and HR 2.14,95%CI:1.48-3.09, respectively) while age, MV, higher fluid balance, and AKI were independent predictors of mortality. Conclusions: AKI was associated with incident in-hospital infections. However, newly occurring infections were not associated with an increased risk of mortality. Further studies are needed to understand how AKI affects distant organ function and associated clinical outcomes. (C) 2018 Elsevier Inc. All rights reserved.