Palabras clave
Terapia de Reemplazo Renal
Sepsis
Unidades de Cuidados Intensivos
Resultados de Cuidados Críticos
Cómo citar
Copyright © | Todos los derechos reservados.
La revista posee los derechos de autor exclusivos para la publicación de este artículo en los términos de la ley brasileña 9610/98.
Reproducción parcial
El uso de partes de los textos, figuras y cuestionario del artículo es libre, siendo obligatoria la citación de los autores y revista.
Reproducción total
Está expresamente prohibido y debe ser autorizado por la revista.
Resumen
Objetivo: Identificar los factores que influyen en los resultados clínicos de pacientes adultos ingresados en la Unidad de Cuidados Intensivos con lesión renal aguda asociada a sepsis (LRA-AS). Métodos: Revisión de alcance. La búsqueda se realizó en las bases de datos LILACS, PubMed/MEDLINE, Scopus y Web of Science. La muestra contiene 19 artículos publicados entre el año 2020 y 2024. Se extrajeron autores, año, país, diseño metodológico y resultados. Posteriormente, se seleccionaron mediante la lectura del título y el resumen y, posteriormente, mediante la lectura completa, con categorización por resultados clínicos. La síntesis de los resultados fue descriptiva. Resultados: Los estudios demostraron que la aparición temprana de LRA-AS, la disfunción renal persistente y una mayor gravedad clínica se asocian con peores resultados clínicos. Factores como alteraciones hemodinámicas, balance hídrico positivo, biomarcadores emergentes, enfermedad renal crónica, obesidad y diferencias metabólicas influyeron significativamente en estos resultados. Se observó una concentración de estudios asiáticos y una ausencia de estudios brasileños. Consideraciones finales: Los hallazgos refuerzan la relevancia del reconocimiento temprano de la LRA-AS y la estratificación continua del riesgo renal. La escasez de estudios nacionales y la heterogeneidad metodológica constituyen limitaciones importantes.
Referencias
AHN YH, et al. Early sepsis-associated acute kidney injury and obesity. JAMA Network Open, 2024; 7(2): e2354923.
LUO X, et al. Early recovery status and outcomes after sepsis-associated acute kidney injury in critically ill patients. Journal of Central South University Medical Sciences, 2022; 47(5): 535–545.
INCI K, et al. Factors and outcomes related to new-onset acute kidney injury in septic medical intensive care unit patients. Northern Clinics of Istanbul, 2024; 11(5): 414–421.
JIANG W, et al. The influence of gender on the epidemiology of and outcome from sepsis-associated acute kidney injury in ICU. European Journal of Medical Research, 2024; 29: 56.
KUWABARA S, et al. The pathophysiology of sepsis-associated AKI. Clinical Journal of the American Society of Nephrology, 2022; 17(7): 1050–1069.
LEGRAND M, et al. Sepsis-associated acute kidney injury: recent advances in enrichment strategies, sub-phenotyping and clinical trials. Critical Care, 2024; 28(1): 92.
LIN J, et al. Impact of cumulative fluid balance during continuous renal replacement therapy on mortality in patients with septic acute kidney injury. Frontiers in Medicine, 2021; 8: 762112.
CARLOS LMC, et al. Sepsis-associated acute kidney injury. Critical Care Clinics, 2021; 37(2): 279–301.
MONARD C, et al. Epidemiology and outcomes of early versus late septic acute kidney injury in critically ill patients. Anaesthesia, Critical Care & Pain Medicine, 2024; 43(1): 101332.
NANDAGOPAL N, et al. Comparison of epidemiology and outcomes of acute kidney injury in critically ill patients with and without sepsis. Indian Journal of Critical Care Medicine, 2020; 24(4): 258–262.
KDIGO. Clinical Practice Guideline for Acute Kidney Injury. Kidney International Supplements, 2012; 2(1): 1–138. Disponível em: http://www.kdigo.org/clinical_practice_guidelines/AKI.php. Acessado em: 29 de setembro de 2025.
OUZZANI M, et al. Rayyan—a web and mobile app for systematic reviews. Systematic Reviews, 2016; 5(1): 210.
PEERAPORNRATANA S, et al. Acute kidney injury from sepsis: current concepts, epidemiology, pathophysiology, prevention and treatment. Kidney International, 2019; 96(5): 1083–1099.
PENG J, et al. No sex differences in the incidence, risk factors and clinical impact of acute kidney injury in critically ill patients with sepsis. Frontiers in Immunology, 2022; 13: 895018.
POSTON JT, KOYNER JL. Sepsis associated acute kidney injury. BMJ, 2019; 364: k4891.
PRESCOTT HC, OSTERMANN M. What is new and different in the 2021 Surviving Sepsis Campaign guidelines. Medizinische Klinik Intensivmedizin und Notfallmedizin, 2023; 118(Suppl 2): 75–79.
RUDD KE, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017. Lancet, 2020; 395(10219): 200–211.
OMS. Sepsis. Organização Mundial da Saúde. 2024. Disponível em: https://www.who.int/news-room/fact-sheets/detail/sepsis. Acessado em: 29 set. 2025.
SEYMOUR CW, et al. Assessment of clinical criteria for sepsis: Sepsis-3. JAMA, 2016; 315(8): 762–774.
SINGER M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA, 2016; 315(8): 801–810.
SONG MJ, et al. Epidemiology of sepsis-associated acute kidney injury in critically ill patients. Critical Care, 2024; 28: 383.
TAKKAVATAKARN K, et al. Machine learning derived serum creatinine trajectories in acute kidney injury in critically ill patients with sepsis. Critical Care, 2024; 28: 156.
TAO X, et al. Combining renal cell arrest and damage biomarkers to predict progressive AKI in patients with sepsis. BMC Nephrology, 2021; 22: 415.
TRICCO AC, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR). Annals of Internal Medicine, 2018; 169(7): 467–473.
UHEL F, et al. Mortality and host response aberrations associated with transient and persistent acute kidney injury in critically ill patients with sepsis. Intensive Care Medicine, 2020; 46(8): 1576–1589.
WANG DH, et al. Attributable mortality of acute kidney injury among critically ill patients with sepsis. BMC Nephrology, 2024; 25: 125.
WANG M, et al. The effects of timing onset and progression of AKI on the clinical outcomes in AKI patients with sepsis. Renal Failure, 2023; 45(1): 1–10.
WANG Z, et al. Acute kidney injury-attributable mortality in critically ill patients with sepsis. PeerJ, 2022; 10: e13184.
WHITE KC, et al. Sepsis-associated acute kidney injury in the intensive care unit. Intensive Care Medicine, 2023; 49(9): 1079–1089.
WHITE KC, et al. Sepsis-associated acute kidney injury in patients with chronic kidney disease. Nephrology, 2024; 29(12): 838–848.
XU H, et al. L-shaped association between triglyceride-glucose body mass index and short-term mortality in ICU patients with sepsis-associated acute kidney injury. Frontiers in Medicine, 2024; 11: 1500995.
YANG Y, et al. Incidence, risk factors and clinical outcomes of septic acute renal injury in cancer patients with sepsis admitted to the ICU. Frontiers in Medicine, 2022; 9: 1015735.
ZARBOCK A, et al. Sepsis-associated acute kidney injury: consensus report of the 28th ADQI workgroup. Nature Reviews Nephrology, 2023; 19(6): 401–417.