National Kidney Month: The Sepsis Connection
March 8, 2018
March is National Kidney Month, a time that may have particularly significant meaning for many sepsis survivors. Kidney infections can cause sepsis, but sepsis can also cause damage to previously healthy kidneys, as it can to any organ. Here, we explain how kidneys and sepsis can be connected.
Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection. Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction, and/or amputations.
Kidney stones and kidney infections
Kidney stones are very common. One in every 11 people in the United States experiences at least one stone in their lifetime.(1) It’s often said that a kidney stone is one of the most painful things you can experience as it moves through the kidney to the ureters. For most people, the stones pass and the pain goes away. However, sometimes the stones become stuck in the kidney and blocks urine flow. The urine then backs up, possibly causing an infection.
Sepsis Alliance has collected over 800 stories of people who have been affected by sepsis and over 50 of these stories involve people who had kidney stones.
Urinary tract infections and kidney infections (pyelonephritis)
Urinary tract infections (UTI) are infections that occur most often in the bladder, but they can occur anywhere in the urinary tract. Most kidney infections begin as infections lower in the urinary tract that spread.
Over 100 of our Faces of Sepsis contributors said that their sepsis was caused by a UTI.
Diabetes and kidney disease
Diabetes is a chronic illness that increases your overall risk of developing kidney disease. In fact, the National Kidney Foundation states that diabetes is a major risk factor for kidney disease. They also say that about 30% of people with type 1 diabetes and 10 to 40% of those with type 2 diabetes will develop kidney failure at some point.(2)
Diabetes also increases your risk of developing an infection. One complication associated with diabetes is nerve damage. If nerve damage occurs in the bladder, it might be difficult to sense when your bladder is full and you may not urinate as frequently as you should. If urine remains too long in your bladder, bacteria can grow, causing an infection. , urine could back up into your kidney, also causing an infection.
Chronic kidney disease and sepsis
Chronic kidney (renal) disease, or CKD, develops slowly over years, and most people don’t have symptoms until there has been a significant amount of kidney damage. Chronic kidney disease affects about 14% of the population in the United States.(3) While kidney disease itself doesn’t cause sepsis, it can put you at risk for developing sepsis in a few different ways. Certain types of CKD, such as medullary sponge kidney, make it easier to develop kidney stones, for example.
People with severe chronic kidney disease or end-stage renal failure may have to undergo regular dialysis to clear their blood of waste that would ordinarily be filtered out by the kidneys. Hemodialysis is a procedure where your blood is filtered through a machine. Peritoneal dialysis is a procedure that can often be done at home. A special fluid flows through a catheter in your abdomen and the fluid absorbs waste. The fluid is then drained from your abdomen and discarded.
If you are undergoing hemodialysis, the nurses need regular access to a vein to allow your blood to flow from your body to the machine and then back again once the blood has been cleaned. This is done through either a fistula or a graft, which are access points in your arm, or a central line catheter, which is usually inserted in a vein in your chest. Each time dialysis is performed, there is a risk of infection in one of the access points. In order to prevent an infection, the procedure is done with a sterile technique, and in between sessions, the access sites must be protected as much as possible.
Peritoneal dialysis is not as common as hemodialysis but may be recommended if you still have some kidney function. Infections can occur inside your abdomen where the fluid is held or around the catheter itself.
Acute kidney injury caused by sepsis
Sepsis and septic shock are among the most common causes of acute kidney injury (AKI), a sudden and temporary loss of kidney function. Patients who have AKI while battling sepsis may have to undergo dialysis until their kidneys begin to function again. In most cases, kidney function does return, but there can be some long-term effects resulting from kidney damage, such as fluid retention, high blood pressure, or heart disease. Occasionally, the kidneys don’t recover at all and a kidney transplant may be necessary.