Risk Factors for chronic kidney disease (CKD) and Septic Shock with Hypertension in Adults and Children

R. Mohamad Javier^1*Jonathan Salim²Bethari Lekso Aji³Benardinus Prima Ardjie Pradipta⁴Choirin Nur⁵Iqbal Muhammad⁶Livaldi Naufal Aflah⁷Immaculata Agata Bornok Rettauli⁸Cristal Audrey⁹Yosua Darmadi Kosen¹⁰Adhitya Fajriyadi¹¹Nourma Sabila¹²Fernando Salipadang¹³Mahardika Adhitya Nugraha^14,15Nadhira Yuisi Cheda¹⁶Andra Purwanto Yogatama Putra^17,18Dhial Falah Mahasin¹⁹Mutiara Delia Subiyanto¹⁵Irma Wijayaningtyas²⁰Arkan Zikri Berlian¹⁴Muhamad Zulfikar Hadiaturahman¹⁶Ratna Kumala Luthfi²¹Muhammad Reva Aditya²²Hafidha Camila Arif²³Kristian Kurniawan²⁴

• ¹Rumah Sakit Universitas Indonesia, Depok, Indonesia
• ²RSUD Kalideres, Kalideres, Indonesia
• ³Rumah Sakit Dharmais Pusat Kanker Nasional, West Jakarta, Indonesia
• ⁴RS Lavalette Malang, Malang, Indonesia
• ⁵RSIA Haji Batu, Batu, Indonesia
• ⁶RSU Nurussyifa Kudus, Klaling, Indonesia
• ⁷RSU Duta Mulya, Banjar, Indonesia
• ⁸Altius Hospitals Harapan Indah, Harapan Indah, Indonesia
• ⁹RSIA EKA Grand Family, DKI Jakarta, Indonesia
• ¹⁰Universitas Kristen Maranatha, Bandung, Indonesia
• ¹¹Universitas Tanjungpura, Pontianak, Indonesia
• ¹²Siloam Hospitals Jember, Jember, Indonesia
• ¹³Universitas Sam Ratulangi, Manado, Indonesia
• ¹⁴Rumah Sakit Dr Cipto Mangunkusumo, Central Jakarta, Indonesia
• ¹⁵Universitas Islam Sultan Agung, Semarang, Indonesia
• ¹⁶Universitas Kristen Indonesia, East Jakarta, Indonesia
• ¹⁷Universitas Gadjah Mada, Yogyakarta, Indonesia
• ¹⁸Rumah Sakit Umum Pusat Dr Sardjito, Sleman, Indonesia
• ¹⁹UPN Veteran Jakarta, South Jakarta, Indonesia
• ²⁰RSUD Prembun, Kebumen, Indonesia
• ²¹RSU Aisyiyah Klaten, Klaten, Indonesia
• ²²Universitas Brawijaya, Malang, Indonesia
• ²³Universitas Islam Negeri Maulana Malik Ibrahim Malang, Malang, Indonesia
• ²⁴Universitas Katolik Indonesia Atma Jaya Fakultas Kedokteran dan Ilmu Kesehatan, South Jakarta, Indonesia

Background: Chronic kidney disease (CKD) affects nearly 10% of the global population and often progresses silently to end-stage renal disease, requiring dialysis or transplantation. Hypertension, prevalent in both adults and children, is a key driver of CKD progression. Acute kidney injury (AKI), particularly sepsis-associated AKI (S-AKI), poses a critical risk for long-term renal dysfunction, especially in patients with pre-existing CKD. S-AKI, defined by abrupt renal function decline during sepsis or septic shock, can accelerate CKD progression, yet its risk factors and outcomes across pediatric and adult populations remain incompletely characterized. Objective: Aims to systematically evaluate existing research on the relationship between Risk Factors for CKD and Septic Shock with Hypertension in Adults and Children. Methods: A systematic literature search was conducted using PubMed, Google Scholar, and the Cochrane Library for studies published between 2004 and 2024. Search terms included "chronic kidney disease," "septic shock," "hypertension," and "acute kidney injury." After applying PRISMA-based screening and eligibility criteria, 9 studies were included for qualitative synthesis. Results: A total of 762 articles were identified through database searching. After screening and eligibility assessment, 9 studies were included in the final synthesis. The findings revealed that both CKD and hypertension are significant independent risk factors for S-AKI and septic shock. Preexisting albuminuria, uncontrolled blood pressure, advanced age, and diabetes mellitus were frequently associated with poor outcomes. Several studies highlighted the role of MPP and fluid resuscitation strategies in preventing AKI progression in septic patients. In pediatric populations, a history of AKI was strongly associated with new-onset hypertension and subsequent CKD development, increasing vulnerability to severe septic complications. Conclusion: CKD and hypertension significantly increase the risk of septic complications and worsen renal outcomes, particularly in patients with fluid management challenges. Early identification of high-risk patients, individualized hemodynamic targets, and tailored fluid resuscitation strategies are critical in reducing morbidity and mortality. Special attention is needed in pediatric patients with limited nephron reserve, where long-term surveillance and early intervention may improve outcomes.