Acute Kidney Injury in Critically Ill Patients with Cutaneous-origin Sepsis: A Systematic Review
Bibliographic record
Abstract
Aims: This systematic review aims to synthesize current evidence regarding the incidence, clinical progression, and therapeutic management of acute kidney injury (AKI) in adult patients with sepsis originating from severe dermatologic infections. It emphasizes the clinical significance of cutaneous-origin sepsis, the role of risk factors such as hypotension and inflammatory markers, and the importance of a multidisciplinary approach involving nephrology, dermatology, and infectious disease. Study Design: Systematic literature review. The review followed PRISMA guidelines. Place and Duration of Study: Databases searched (PubMed, SciELO, LILACS, BVS, MEDLINE) between January 2014 and April 2024. Methodology: The review followed PRISMA guidelines. Studies published between 2014 and 2024 were included if they addressed AKI in the context of dermatologic-origin sepsis. Eligible study designs included observational studies, case series, and clinical reports in English, Portuguese, or Spanish. Data extraction was performed independently by two reviewers using a standardized form. Quality assessment used the Newcastle-Ottawa Scale (NOS) and JBI checklist, depending on study type. Results: A total of 582 studies were initially identified, with 14 meeting all eligibility criteria. Included studies involved 2,761 adult ICU patients with infections such as deep cellulitis, necrotizing fasciitis, infected ulcers, and burns. AKI incidence ranged from 21.4% to 64.7%. The presence of AKI was associated with increased need for renal replacement therapy (RRT), longer hospital stays, and higher mortality. Risk factors for poor renal outcomes included sustained hypotension, early vasopressor use, elevated lactate and procalcitonin levels, and persistent oliguria. Common interventions included early antibiotic therapy, volume resuscitation, avoidance of nephrotoxins, and the use of CRRT in unstable patients. Conclusion: Sepsis of dermatologic origin poses a substantial risk for AKI development, with clinical and mortality impacts comparable to other septic sources. Early identification and integrated multidisciplinary management are crucial for improving renal outcomes. Further prospective and multicenter research is needed to refine diagnostic tools and intervention protocols specific to this high-risk population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.035 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.007 |
| Bibliometrics | 0.011 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".