---
title: "Early systolic blood pressure and 1-year outcomes in non-critically ill sepsis-associated AKI"
id: "pubmed-42768944"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42768944"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42768944/"
doi: "10.1080/07853890.2026.2735092"
published_at: "2026-09-22T09:36:32.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Early systolic blood pressure and 1-year outcomes in non-critically ill sepsis-associated AKI
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42768944
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42768944/)
- **DOI:** [10.1080/07853890.2026.2735092](https://doi.org/10.1080%2F07853890.2026.2735092)
- **Published At:** 2026-09-22T09:36:32.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This single-center retrospective cohort evaluated the association between early mean **systolic blood pressure** (SBP) in the first 48 hours and one-year clinical outcomes in adults with **sepsis-associated acute kidney injury (SA-AKI)**. - SA-AKI was defined by a SOFA score increase ≥2 and AKI onset within 48 hours of admission; the study period spanned 2011–2020 and included 476 patients after screening 2,920. - Mean SBP over the first 48 hours (seven measurements: baseline and every 8 hours) was categorized into ≤100, 101–120, 121–140, and >140 mmHg. - Primary composite outcome: ≥25% decline in estimated glomerular filtration rate (eGFR), long-term dialysis, or one-year mortality; patients were followed for one year. - Cohort characteristics: mean age 68.4 ± 14.5 years; 55% male; AKI stages I, II, III occurred in 55%, 21%, and 24% respectively. - The composite outcome was most frequent in the **≤100 mmHg** SBP group (80%) versus 51% (101–120), 50% (121–140), and 46% (>140); p < 0.001. - Adjusted analyses showed mean SBP ≤100 mmHg was associated with higher risk of the composite outcome (HR 1.84; 95% CI 1.15–2.93; p = 0.010). - One-year mortality was highest in the ≤100 mmHg group (73%); adjusted hazards for one-year mortality (HR 2.89; 95% CI 1.68–4.99) and 30-day mortality (HR 2.79; 95% CI 1.12–6.96) were increased in this group. - The authors conclude that early mean SBP ≤100 mmHg within 48 hours after admission in non-critically ill SA-AKI patients was associated with worse one-year outcomes, largely driven by higher mortality, and that early SBP may be a useful prognostic marker. - Keywords reported include acute kidney disease, blood pressure, hemodynamic, and sepsis; specific limitations or additional methodological details beyond the abstract were not reported in the source.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 22. # Association between early systolic blood pressure and clinical outcomes in non-critically ill patients with sepsis-associated acute kidney injury: a retrospective cohort study [Teerawat Sriwalosakul](https://pubmed.ncbi.nlm.nih.gov/?term=Sriwalosakul+T&cauthor_id=42768944)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#full-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand."), [Surachet Vongsanim](https://pubmed.ncbi.nlm.nih.gov/?term=Vongsanim+S&cauthor_id=42768944)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#full-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand."), [Karn Pongsuwan](https://pubmed.ncbi.nlm.nih.gov/?term=Pongsuwan+K&cauthor_id=42768944)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#full-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand."), [Prit Kusirisin](https://pubmed.ncbi.nlm.nih.gov/?term=Kusirisin+P&cauthor_id=42768944)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#full-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand."), [Surapon Nochaiwong](https://pubmed.ncbi.nlm.nih.gov/?term=Nochaiwong+S&cauthor_id=42768944)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#full-view-affiliation-2 "Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#full-view-affiliation-3 "Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand."), [Chidchanok Ruengorn](https://pubmed.ncbi.nlm.nih.gov/?term=Ruengorn+C&cauthor_id=42768944)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#full-view-affiliation-2 "Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#full-view-affiliation-3 "Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand."), [Kajohnsak Noppakun](https://pubmed.ncbi.nlm.nih.gov/?term=Noppakun+K&cauthor_id=42768944)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#full-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#full-view-affiliation-2 "Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.") Affiliations Expand ### Affiliations * 1 Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. * 2 Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand. * 3 Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand. * PMID: **42768944** * DOI: [ 10.1080/07853890.2026.2735092 ](https://doi.org/10.1080/07853890.2026.2735092) Item in Clipboard # Association between early systolic blood pressure and clinical outcomes in non-critically ill patients with sepsis-associated acute kidney injury: a retrospective cohort study Teerawat Sriwalosakul et al. Ann Med. 2026 Dec. Show details Display options Display options Format Abstract PubMed PMID Ann Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Ann+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Ann+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42768944/) . 2026 Dec;58(1):2735092. doi: 10.1080/07853890.2026.2735092. Epub 2026 Sep 22. ### Authors [Teerawat Sriwalosakul](https://pubmed.ncbi.nlm.nih.gov/?term=Sriwalosakul+T&cauthor_id=42768944)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#short-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand."), [Surachet Vongsanim](https://pubmed.ncbi.nlm.nih.gov/?term=Vongsanim+S&cauthor_id=42768944)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#short-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand."), [Karn Pongsuwan](https://pubmed.ncbi.nlm.nih.gov/?term=Pongsuwan+K&cauthor_id=42768944)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#short-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand."), [Prit Kusirisin](https://pubmed.ncbi.nlm.nih.gov/?term=Kusirisin+P&cauthor_id=42768944)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#short-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand."), [Surapon Nochaiwong](https://pubmed.ncbi.nlm.nih.gov/?term=Nochaiwong+S&cauthor_id=42768944)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#short-view-affiliation-2 "Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#short-view-affiliation-3 "Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand."), [Chidchanok Ruengorn](https://pubmed.ncbi.nlm.nih.gov/?term=Ruengorn+C&cauthor_id=42768944)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#short-view-affiliation-2 "Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#short-view-affiliation-3 "Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand."), [Kajohnsak Noppakun](https://pubmed.ncbi.nlm.nih.gov/?term=Noppakun+K&cauthor_id=42768944)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#short-view-affiliation-1 "Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42768944/#short-view-affiliation-2 "Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand.") ### Affiliations * 1 Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. * 2 Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand. * 3 Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand. * PMID: **42768944** * DOI: [ 10.1080/07853890.2026.2735092 ](https://doi.org/10.1080/07853890.2026.2735092) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Sepsis-associated acute kidney injury (SA-AKI) is associated with poor outcomes. Evidence regarding the relationship between early systolic blood pressure (BP) and clinical outcomes in non-critically ill patients with SA-AKI remains limited. This study aimed to investigate the association between mean systolic BP during the first 48 h after admission and one-year clinical outcomes in this population. **Methods:** We conducted a single-center retrospective cohort study of non-critically ill adults with SA-AKI admitted between 2011 and 2020. SA-AKI was defined by a sequential organ failure assessment (SOFA) score increase ≥2 and AKI occurring within 48 h of admission. The exposure was mean systolic BP over the first 48 h (seven measurements at baseline and every 8 h), categorized as ≤100, 101-120, 121-140, and >140 mmHg. Patients were followed for one year. The primary outcome was a composite of ≥25% decline in estimated glomerular filtration rate, long-term dialysis, and one-year mortality. **Results:** Of 2,920 screened patients, 476 were included. Mean age was 68.4 ± 14.5 years, and 55% were male. AKI stages I, II, and III occurred in 55%, 21%, and 24%, respectively. The primary composite outcome was most frequent in the ≤100 mmHg group (80%) compared with 101-120 (51%), 121-140 (50%), and >140 mmHg (46%) (_p_ < 0.001). In adjusted analyses, mean systolic BP ≤100 mmHg was associated with higher composite outcome (HR 1.84, 95% CI 1.15-2.93; _p_ = 0.010). One-year mortality was highest in systolic BP ≤100 mmHg group (73% vs. 32% in 121-140 mmHg; _p_ < 0.001), with increased adjusted hazards for one-year mortality (HR 2.89, 95% CI 1.68-4.99) and 30-day mortality (HR 2.79, 95% CI 1.12-6.96). **Conclusion:** In non-critically ill patients with SA-AKI, early mean systolic BP ≤100 mmHg within 48 h was associated with worse one-year outcomes, driven largely by higher mortality. Early systolic BP may serve as a prognostic marker for high-risk patients. **Keywords:** Acute kidney disease; acute renal failure; acute tubular necrosis; blood pressure; hemodynamic; sepsis. ## Plain language summary Evidence regarding the association between early blood pressure and outcomes in non-critically ill patients with sepsis-associated AKI is limited.In our cohort, early mean systolic blood pressure ≤100 mmHg within 48 hours was associated with worse one-year outcomes, primarily driven by increased mortality.Early systolic blood pressure may serve as a prognostic marker for high-risk patients requiring closer attention. 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