{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:52:00Z","timestamp":1790009520042,"version":"4.0.1"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec017\">\n<jats:title>Background<\/jats:title>\n<jats:p>Sepsis-associated acute kidney injury (SA-AKI) is a common and life-threatening complication in critically ill patients. Studies have shown that the use of beta-blockers improves hemodynamics and the risk of death in patients with sepsis. However, the association between beta-blockers use and the risk of AKI in patients with sepsis remains poorly understood. The present study aimed to evaluate this potential association.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec018\">\n<jats:title>Method<\/jats:title>\n<jats:p>Sepsis patients for this retrospective cohort study were extracted from the Medical Information Mart for Intensive Care-IV (MIMIC) database. Propensity score matching (PSM) was used to balance the basic characteristics between beta-blocker users and non-users. Univariate and multivariable logistic regression analysis were employed to evaluate the association between early use of beta-blocker and SA-AKI. Odds ratio (OR) and 95% confidence interval (CI) were estimated as effect measurements.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec019\">\n<jats:title>Results<\/jats:title>\n<jats:p>Totally 4,419 patients with sepsis were enrolled in our study. The follow-up period was from the 24<jats:sup>th<\/jats:sup> hour of intensive care unit (ICU) admission to the occurrence of AKI or ICU discharge, with 2,122 (48.02%) cases of developed AKI. After PSM, a lower SA-AKI risk was observed in the early use of the beta-blockers group compared to the non-user group (adjusted OR: 0.80; 95%CI: 0.64\u20130.99). Similar associations of early use of beta-blockers and SA-AKI were observed in patients younger than 65 years old, male, without comorbidities, and with Simplified Acute Physiology Score II\/Charlson comorbidity index scores below the median (all <jats:italic>P\u2009<\/jats:italic>&lt;\u20090.05).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec020\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In ICU patients with sepsis, early use of beta-blockers is associated with a reduced risk of AKI, which may help reduce renal impairment and improve survival. Further studies are needed to verify the underlying mechanisms of beta-blockers in the development of SA-AKI.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0325980","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T17:29:10Z","timestamp":1750094950000},"page":"e0325980","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association between the early use of beta-blocker and the risk of sepsis-associated acute kidney injury: A retrospective cohort study using the MIMIC-IV database"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0004-7937","authenticated-orcid":true,"given":"Canmin","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingfang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfeng","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"issue":"1","key":"pone.0325980.ref001","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1038\/s41392-021-00816-9","article-title":"Signaling pathways and intervention therapies in sepsis","volume":"6","author":"Y-Y Zhang","year":"2021","journal-title":"Signal Transduct Target Ther"},{"issue":"10141","key":"pone.0325980.ref002","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(18)30696-2","article-title":"Sepsis and septic shock","volume":"392","author":"M Cecconi","year":"2018","journal-title":"Lancet"},{"key":"pone.0325980.ref003","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study","volume":"395","author":"KE Rudd","year":"2020","journal-title":"Lancet"},{"issue":"6","key":"pone.0325980.ref004","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1038\/s41569-020-00492-2","article-title":"Pathophysiology of sepsis-induced cardiomyopathy","volume":"18","author":"SM Hollenberg","year":"2021","journal-title":"Nat Rev Cardiol"},{"issue":"12","key":"pone.0325980.ref005","doi-asserted-by":"crossref","first-page":"3360","DOI":"10.1016\/j.jtha.2023.05.028","article-title":"Mechanisms and management of the coagulopathy of trauma and sepsis: trauma-induced coagulopathy, sepsis-induced coagulopathy, and disseminated intravascular coagulation","volume":"21","author":"T Iba","year":"2023","journal-title":"J Thromb Haemost"},{"issue":"6","key":"pone.0325980.ref006","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1038\/s41581-023-00683-3","article-title":"Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup","volume":"19","author":"A Zarbock","year":"2023","journal-title":"Nat Rev Nephrol"},{"issue":"9","key":"pone.0325980.ref007","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1007\/s00134-023-07138-0","article-title":"Sepsis-associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. 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