Introduction:
Malnutrition is common among critically ill patients and can significantly impact outcomes, particularly in those with acute kidney injury (AKI) due to sepsis. However, the prognostic significance of malnutrition in septic AKI patients remains not well-established. This study aimed to assess the relationship between malnutrition risk and prognosis in patients with sepsis-induced AKI.
Methods:
We conducted a retrospective study involving 236 patients with sepsis-induced AKI admitted to the ICU of the Tertiary Hospital in Vietnam between January 2021 and February 2024. Patients under 18 years, those with pre-existing chronic kidney disease, postrenal obstruction, or prior kidney transplantation were excluded. Sepsis was defined according to Sepsis-3 criteria, and AKI was diagnosed based on AKIN criteria. Malnutrition risk was evaluated using the modified NUTRIC (mNUTRIC) score, calculated within the first 24 hours of admission. The primary outcome was 28-day mortality.
Results:
The median age of the study population was 71 years, and 60.6% were male. The percentage of septic shock was 86% of patients. The 28-day mortality rate was 39.8%. The mNUTRIC score was significantly higher in the deceased group [6 (5–7)] compared to the surviving group [5 (3–6), p < 0.001]. Moreover, a higher percentage of patients with an mNUTRIC score ≥ 5 was observed in the deceased group (80.8%) compared to the survivors (59.1%, p < 0.001). The mNUTRIC score demonstrated predictive value for 28-day mortality, with an area under the curve (AUC) of 0.64. A cut-off score of 5 had a sensitivity of 59.8% and a specificity of 69.1%. Multivariate Cox regression analysis revealed that an mNUTRIC score ≥ 5 was an independent predictor of 28-day mortality (OR 2.08, p = 0.025).
Conclusions:
The study demonstrates that a high malnutrition risk, as indicated by an mNUTRIC score ≥ 5, is significantly associated with increased 28-day mortality in patients with sepsis-induced AKI.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.