R. Mohamad Javier, Jonathan Salim, Bethari Lekso Aji, Benardinus Prima Ardjie Pradipta, Choirin Nur, Iqbal Muhammad, Livaldi Naufal Aflah, Immaculata Agata Bornok Rettauli, Cristal Audrey, Irma Wijayaningtyas, Yosua Darmadi Kosen, Adhitya Fajriyadi, Nourma Sabila, Fernando Pangruruk Salipadang, Mahardika Adhitya Nugraha, Nadhira Yuisi Cheda, Andra Purwanto Yogatama Putra, Dhial Falah Mahasin, Mutiara Delia Subiyanto, Arkan Zikri Berlian, Muhamad Zulfikar Hadiaturahman, Ratna Kumala Luthfi, Muhammad Reva Aditya, Hafidha Camila Arif, Kristian Kurniawan
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. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php, identifier PROSPERO (CRD420251146866). Copyright © 2025 Javier, Salim, Aji, Pradipta, Nur, Muhammad, Aflah, Rettauli, Audrey, Wijayaningtyas, Kosen, Fajriyadi, Sabila, Salipadang, Nugraha, Cheda, Putra, Mahasin, Subiyanto, Berlian, Hadiaturahman, Luthfi, Aditya, Arif and Kurniawan.
Department of Cardiology and Vascular Medicine, Universitas Indonesia Hospital, Java, Depok, Indonesia; Kalideres Regional General Hospital (RSUD Kalideres), Jakarta, Indonesia; Dharmais National Cancer Center Hospital, Jakarta, Indonesia; Lavalette Hospital, Malang, Indonesia; Haji Batu Mother & Child Hospital, Batu, Indonesia; Faculty of MedicineMuhammadiyah University of Malang, Java, Malang, Indonesia; Nurussyifa General Hospital, Kudus, Indonesia; Duta Mulya General Hospital, Java, Bekasi, Indonesia; Altius Hospitals Harapan Indah, Java, Bekasi, Indonesia; EKA Grand Family Mother and Child Hospital (RSIA EKA Grand Family), Banten, Tangerang, Indonesia; Prembun Regional Hospital (RSUD Prembun), Java, Kebumen, Indonesia; Faculty of Medicine, Jenderal Soedirman University, Java, Purwokerto, Indonesia; Faculty of Medicine, Maranatha Christian University, Java, Bandung, Indonesia; Faculty of Medicine, Tanjungpura University, Kalimantan, Pontianak, Indonesia; Siloam Hospital, Jember, Indonesia; Faculty of Medicine, Sam Ratulangi University, Sulawesi, Manado, Indonesia; Division of Psychosomatic and Palliative Medicine, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital (RSCM), Jakarta, Indonesia; Faculty of MedicineSultan Agung Islamic University, Java, Semarang, Indonesia; Faculty of Medicine, Indonesian Christian University, Jakarta, Indonesia; Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia; Dr. Sardjito Hospital, Yogyakarta, Indonesia; Faculty of Medicine, UPN Veteran Jakarta, Jakarta, Indonesia; Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital (RSCM), Jakarta, Indonesia; Aisyiyah Klaten General Hospital (RSU Aisyiyah Klaten), Java, Klaten, Indonesia; Faculty of Medicine, Brawijaya University, Java, Malang, Indonesia; Faculty of Medicine, Maulana Malik Ibrahim State Islamic University, Malang, Indonesia; Faculty of Medicine and Science, Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia
