Effect of Chronic Kidney Disease on the Mortality Rate of Patient with Sepsis

Muhamad Ibnu Aziz, Evi Nurhayatun, Ratih Tri Kusumadewi, Agung Susanto

Abstract

Introduction: Sepsis is a deathly disease caused by a dysregulation of the body's response to infection. The mortality rate of sepsis has been discovered to be almost equivalent to 20% of the global mortality rate. Comorbidity is one of the non-modifiable risk factors of sepsis. Chronic kidney disease is a comorbid risk factor for sepsis development. Decreasing GFR and albuminuria in chronic kidney disease is strongly associated with an increased mortality rate due to infection. Sepsis with chronic kidney disease shows a higher SOFA score than sepsis without chronic kidney disease. This study aims to determine the effect of chronic kidney disease on the mortality rate of patients with sepsis.

Methods: This study is an observational analytic study with a cross-sectional approach. The data retrieval used purposive sampling, and the sample comprised 90 respondents. Data were taken from medical records of the patients with sepsis hospitalized in Dr Moewardi Hospital from January 2016 to May 2021. Data were analyzed using the Chi-Square test.

Results: Chronic kidney disease significantly affected the sepsis mortality rate with p-value = 0.033 (p < 0.05). The prevalence ratio was 2.531 (95%CI, 1.07 – 5.97).

Conclusion: Chronic kidney disease significantly affects the increasing mortality rate of sepsis patients.

Keywords: Chronic kidney disease; Mortality; Sepsis,

Keywords

Chronic kidney disease; Mortality; Sepsis,

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References

  1. Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8):801.
  2. Rudd et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet. 2020;395(10219):200–211.
  3. Fathi M, Markazi-Moghaddam N, and Ramezankhani A. A systematic review of risk factors associated with sepsis in patients admitted to intensive care units. Australian Critical Care. 2016;32(2):155–164.
  4. Centres for Disease Control and Prevention. What is sepsis? https://www.cdc.gov/sepsis/what-is-sepsis.html (Diakses 27 Januari 2021)
  5. KDIGO. Chapter 1: Definition and Classification of CKD. Kidney International Supplements. 2013;3(1):19–62.
  6. Vaidya SR and Aeddula NR. Chronic Renal Failure. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing: 2020.
  7. Wang HE, Gamboa C, Warnock DG, Muntner P. Chronic Kidney Disease and Risk of Death from Infection. Am J Nephrol. 2011;34(4):330–6.
  8. Mansur A et al. Chronic kidney disease is associated with a higher 90-day mortality than other chronic medical conditions in patients with sepsis. Scientific Reports. 2015:8.
  9. Chang C-H, Fan P-C, Kuo G, Lin Y-S, Tsai T-Y, Chang S-W, et al. Infection in Advanced Chronic Kidney Disease and Subsequent Adverse Outcomes after Dialysis Initiation: A Nationwide Cohort Study. Sci Rep. 2020 Dec;10(1):2938.
  10. Kurts C, Panzer U, Anders H-J, Rees AJ. The immune system and kidney disease: basic concepts and clinical implications. Nat Rev Immunol. 2013 Oct;13(10):738–53.
  11. Syed-Ahmed M, Narayanan M. Immune Dysfunction and Risk of Infection in Chronic Kidney Disease. Advances in Chronic Kidney Disease. 2019 Jan;26(1):8–15.
  12. Xu J, Tong L, Yao J, Guo Z, Lui KY, Hu X, et al. Association of Sex With Clinical Outcome in Critically Ill Sepsis Patients: A Retrospective Analysis of the Large Clinical Database MIMIC-III. Shock. 2019 Aug;52(2):146–51.
  13. Bösch F, Angele MK, Chaudry IH. Gender differences in trauma, shock and sepsis. Military Med Res. 2018 Dec;5(1):35.
  14. Madsen TE et al. The DISPARITY Study: do gender differences exist in Surviving Sepsis Campaign resuscitation bundle completion, completion of

individual bundle elements, or sepsis mortality?, Journal of Critical Care. 2014;29(3):473.e7-473.e11.

  1. Pietropaoli AP, Glance LG, Oakes D, Fisher SG. Gender differences in mortality in patients with severe sepsis or septic shock. Gender Medicine. 2010 Oct;7(5):422–37.
  2. Dossett LA, Swenson BR, Heffernan D, Bonatti H, Metzger R, Sawyer RG, et al. High Levels of Endogenous Estrogens are Associated With Death in the Critically Injured Adult. Journal of Trauma: Injury, Infection & Critical Care. 2008 Mar;64(3):580–5.
  3. Lineberry C, Stein DE. Infection, Sepsis, and Immune Function in the Older Adult Receiving Critical Care. Critical Care Nursing Clinics of North America. 2014 Mar;26(1):47–60.
  4. Chen C-M, Cheng K-C, Chan K-S, Yu W-L. Age May Not Influence the Outcome of Patients with Severe Sepsis in Intensive Care Units. International Journal of Gerontology. 2014 Mar;8(1):22–6.
  5. Centers for Disease Control and Prevention. Does cancer put me at risk for sepsis?. https://www.cdc.gov/sepsis/sepsis-cancer/index.html (Diakses 1 Oktober 2021)
  6. Soares M, Bozza FA, Azevedo LCP, Silva UVA, Corrêa TD, Colombari F, et al. Effects of Organizational Characteristics on Outcomes and Resource Use in Patients With Cancer Admitted to Intensive Care Units. JCO. 2016 Sep 20;34(27):3315–24.
  7. Liu MA, Bakow BR, Hsu T-C, Chen J-Y, Su K-Y, Asiedu EK, et al. Temporal Trends in Sepsis Incidence and Mortality in Patients With Cancer in the US Population. American Journal of Critical Care. 2021 Jul 1;30(4):e71–9.
  8. Cooper AJ, Keller SP, Chan C, Glotzbecker BE, Klompas M, Baron RM, et al. Improvements in Sepsis-associated Mortality in Hospitalized Patients with Cancer versus Those without Cancer. A 12-Year Analysis Using Clinical Data. Annals ATS. 2020 Apr;17(4):466–73.
  9. Shvetsov YB, Ogino MH, Glibetic N, Asato CB, Wilkens LR, Le Marchand L, et al. Association of Sepsis Mortality with Specific Cancer Sites and Treatment Type: The Multiethnic Cohort Study. JPM. 2021 Feb 19;11(2):146.
  10. McPhail S, Johnson S, Greenberg D, Peake M, Rous B. Stage at diagnosis and early mortality from cancer in England. Br J Cancer. 2015 Mar;112(S1):S108–15.

DOI: https://doi.org/10.20961/tscm.v1i1.57829

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