ArticleChest2024
Distribution of Acute and Chronic Kidney Disease Across Clinical Phenotypes for Sepsis.
Article in Chest, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Efficacy of traditional Chinese medicineFrontiers in medicine · 2024Pooled it
- Biochemical phenotypes of acute kidney injury and their association with major adverse kidney events.Renal failure · 2026Article
- Targeting integrated cell death networks in sepsis‑associated acute kidney injury: Shared regulatory nodes and diet‑related small molecule modulation (Review).International journal of molecular medicine · 2026Review
- Development of an interpretable machine learning model for predicting new-onset atrial fibrillation in patients with sepsis-associated acute kidney injury: A retrospective cohort study.Science progress · 2026Article
- Clinical subphenotypes and molecular endotypes in sepsis: toward an integrated and dynamic framework.Annals of intensive care · 2026Review
- The immunology of sepsis: translating new insights into clinical practice.Nature reviews. Nephrology · 2026Review
- Derivation of a novel clinical phenotype of sepsis in critically ill patients: a secondary analysis of a multicentre, prospective, observational study.Frontiers in medicine · 2026Article
- The Clinical View of Sepsis-Associated AKI: How Basic Science Can Help Solve This Problem.Seminars in nephrology · 2025Review
- Treatment effects of Xuebijing injection in patients with sepsis by clinical phenotype: a post hoc analysis of the EXIT-SEP trial.EClinicalMedicine · 2025Article
- Development and validation of a predictive model for continuous renal replacement therapy in sepsis patients using the MIMIC-IV database.Scientific reports · 2025Article
- Acute kidney injury in hospitalized patients with real-life analysis of incidence and clinical impact in Italian hospitals (the SIN-AKI study).Scientific reports · 2025Article
- Nanozymes Targeting Redox Imbalance: A Novel Weapon for Immunomodulation and Organ Protection in Sepsis.International journal of nanomedicine · 2025Review
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundSepsis is the most common cause of acute kidney injury (AKI) in critically ill patients. Four phenotypes (α, β, γ, δ) for sepsis, which have different outcomes and responses to treatment, were described using routine clinical data in the electronic health record. RESEARCH QUESTION: Do the frequencies of AKI, acute kidney disease (AKD), chronic kidney disease (CKD), and AKI on CKD differ by sepsis phenotype? STUDY DESIGN AND
methodsThis was a secondary analysis of a randomized clinical trial of early resuscitation, including patients with septic shock at 31 sites. After excluding patients with end-stage kidney disease and missing data, we determined frequencies of the following clinical outcomes: AKI (defined within 24 h as Kidney Disease: Improving Global Outcomes stages 2 or 3 or stage 1 with tissue inhibitor of metalloproteinases-2 × insulin-like growth factor binding protein 7 value of > 2.0), CKD, and AKD (persistence of AKI at any stage on day 7 after enrollment) across four phenotypes. We performed multivariable logistic regression to assess the risk-adjusted association between development of AKI and AKD and phenotype.
resultsAmong 1,090 eligible patients, 543 patients (50%) had AKI. Across phenotypes, the frequencies of AKI varied, being highest in the δ and β phenotypes (78% and 71%, respectively) and the lowest in the α phenotype (26%; P < .001). AKD occurred most often in the δ phenotype (41%) and least often in the α phenotype (8%; P < .001). The highest frequencies of CKD and of AKI on CKD were found in the β phenotype (53% and 38% respectively; P < .001 for both). In the multivariable logistic regression models (α phenotype as reference), δ phenotype showed the strongest association with AKI (OR, 12.33; 95% CI, 7.81-19.47; P < .001) and AKD (OR, 9.18; 95% CI, 5.44-15.51; P < .001).
interpretationThe rates of AKI and AKD differed across clinical sepsis phenotypes and are more common among patients with phenotypes β and δ. Phenotype β showed a higher level of underlying CKD that predisposed patients to new AKI. The α and γ phenotypes showed lower frequencies of AKI and less progression to AKD.
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