BACKGROUND: Urinary tract infection (UTI) is one of the most common bacterial infections and is often associated with acute kidney injury (AKI). An episode of AKI might contribute to a high mortality rate and long-term morbidity, including chronic kidney disease and end-stage renal disease. The poor prognosis might result from the late detection of the disease and the lack of specific drug-based treatment options. Although several diagnostic biomarkers have been proposed and studied for the early detection of AKI, their clinical applications are limited. Hence, the current study aimed to describe easily recognizable clinical characteristics that could help identify each individual at risk of AKI among UTI patients. METHODS: Data from 1,078 UTI patients from a tertiary referral center in Southern Taiwan were analyzed, and the patients were divided into two groups based on the presence of AKI during hospitalization. Clinical characteristics, including demographic data, clinical parameters, laboratory data, and pathogen type, were analyzed and compared. Multivariate logistic regression analysis was used to evaluate the risk factors for AKI among patients with UTI. RESULTS: A total of 303 patients (28.1%) developed AKI during the hospitalization. Multivariate logistic regression analysis showed that longer hospital stay length (odds ratio [OR], 1.089; 95% confidence interval [CI], 1.054-1.125; P < 0.001), diabetes mellitus (OR, 1.496; 95% CI, 1.097-2.039; P = 0.011), bacteremia (OR, 1.566; 95% CI, 1.129-2.173; P = 0.007), urolithiasis (OR, 1.990; 95% CI, 1.379-2.871; P < 0.001), septic shock (OR, 2.708; 95% CI, 1.889-3.883; P < 0.001), and higher white blood cell (WBC) count (OR, 1.046; 95% CI, 1.020-1.073, P < 0.001) were independently associated with a higher risk of AKI development in UTI patients. Conversely, high fever (OR, 0.689; 95% CI, 0.497-0.955, P = 0.025) and baseline estimated glomerular filtration rate (OR, 0.993; 95% CI, 0.987-0.999, P = 0.016) were independently associated with a decreased risk of AKI in UTI patients. CONCLUSION: Physicians should be acquainted with risk factors for AKI development in UTI patients, which include the longer period of hospital stay, diabetes mellitus, bacteremia, urolithiasis, septic shock, and higher WBC count.
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