A correlation study between septic acute kidney injury and immune function

Objective To explore the correlations between septic acute kidney injury (SAKI) and immune condition and provide the clinical basis of predictable diagnosis and treatment in patients with SAKI. Methods Patients diagnosed with sepsis admitted to department of emergency intensive care unit of Peking Union Medical College Hospital between January 1st, 2013 and September 30th, 2014 were retrospectively studied. A total of 91 patients with sepsis were included, and they were divided into secondary immune deficient (SID) group (n=46) or control group (n=45) . According to the diagnostic criteria and stage of the guidelines of Kidney Disease: Improving Global Outcomes 2012 (KDIGO-AKI 2012) , patients in each group were divided into non-SAKI group (n1=16, n2=23) 、KDIGO-1 group (n1=15, n2=13) 、KDIGO-2 group (n1=11, n2=1) or KDIGO-3 group (n1 =4, n2=8) . The morbidity of each stage and the renal index along with the progression of SAKI was also compared in patients with SAKI in two groups. Results While there was a significant difference in the morbidity of KDIGO-2 (23.9% vs. 2.2%, χ2=0.321, P=0.002) in patients with SAKI between immune deficient group and control group, the morbidity of KDIGO-1 and KDIGO-3 had no significant difference (KDIGO-1 : 32.6% vs. 29.8%, χ2=0.040, P=0.701 ; KDIGO-3: 8.7% vs. 17.8%, χ2=-1.805, P=0.200) . There was also no significant difference in the renal index (ΔScr、ΔeGFR) and progression of SAKI (elapsed days from the diagnosis of sepsis to the occurance and most severe stage of SAKI) in patients with SAKI in two groups (P >0.05) . Conclusion There was no significant difference of the severity of septic acute kidney injury in patients with and without secondary immune deficiency. Inflammatory mediators-induced kidney injury in the process of immune response may not be the main mechanism in SAKI. Key words: Immune condition; Secondary immune deficiency; Septic acute kidney injury; Renal function; Morbidity; Progression; Correlation; Severity