Improved long-term survival and renal recovery after acute kidney injury in hospitalized patients: A 20 year experience

Nephrology ◽  
2016 ◽  
Vol 21 (12) ◽  
pp. 1027-1033 ◽  
Author(s):  
Thorir E. Long ◽  
Martin I. Sigurdsson ◽  
Gisli H. Sigurdsson ◽  
Olafur S. Indridason
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Hospitalized Patients ◽  
Renal Recovery ◽  
Term Survival ◽  
Long Term Survival

Renal recovery and long-term survival following acute kidney injury after coronary artery surgery: a nationwide study

2016 ◽  
Vol 60 (9) ◽  
pp. 1230-1240 ◽  
Author(s):  
S. Helgadottir ◽  
M. I. Sigurdsson ◽  
R. Palsson ◽  
D. Helgason ◽  
G. H. Sigurdsson ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Coronary Artery Surgery ◽  
Term Survival ◽  
Long Term Survival ◽  
Nationwide Study

scholarly journals Association of persistent acute kidney injury and renal recovery with mortality in hospitalised patients

2021 ◽  
Vol 28 (1) ◽  
pp. e100458
Author(s):  
Tezcan Ozrazgat-Baslanti ◽  
Tyler J Loftus ◽  
Yuanfang Ren ◽  
Esra Adiyeke ◽  
Shunshun Miao ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Outcomes ◽  
Resource Use ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Care Hospital ◽  
Term Survival ◽  
Long Term Survival ◽  
Hospitalised Patients

ObjectivesAcute kidney injury (AKI) affects up to one-quarter of hospitalised patients and 60% of patients in the intensive care unit (ICU). We aim to understand the baseline characteristics of patients who will develop distinct AKI trajectories, determine the impact of persistent AKI and renal non-recovery on clinical outcomes, resource use, and assess the relative importance of AKI severity, duration and recovery on survival.MethodsIn this retrospective, longitudinal cohort study, 156 699 patients admitted to a quaternary care hospital between January 2012 and August 2019 were staged and classified (no AKI, rapidly reversed AKI, persistent AKI with and without renal recovery). Clinical outcomes, resource use and short-term and long-term survival adjusting for AKI severity were compared among AKI trajectories in all cohort and subcohorts with and without ICU admission.ResultsFifty-eight per cent (31 500/54 212) had AKI that rapidly reversed within 48 hours; among patients with persistent AKI, two-thirds (14 122/22 712) did not have renal recovery by discharge. One-year mortality was significantly higher among patients with persistent AKI (35%, 7856/22 712) than patients with rapidly reversed AKI (15%, 4714/31 500) and no AKI (7%, 22 117/301 466). Persistent AKI without renal recovery was associated with approximately fivefold increased hazard rates compared with no AKI in all cohort and ICU and non-ICU subcohorts, independent of AKI severity.DiscussionAmong hospitalised, ICU and non-ICU patients, persistent AKI and the absence of renal recovery are associated with reduced long-term survival, independent of AKI severity.ConclusionsIt is essential to identify patients at risk of developing persistent AKI and no renal recovery to guide treatment-related decisions.

scholarly journals Long-term survival in patients with septic acute kidney injury is strongly influenced by renal recovery

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0198269 ◽  
Author(s):  
Marco Fiorentino ◽  
Fadi A. Tohme ◽  
Shu Wang ◽  
Raghavan Murugan ◽  
Derek C. Angus ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Term Survival ◽  
Long Term Survival ◽  
Septic Acute Kidney Injury

scholarly journals The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans

2010 ◽  
Vol 78 (9) ◽  
pp. 926-933 ◽  
Author(s):  
Steven G. Coca ◽  
Joseph T. King ◽  
Ronnie A. Rosenthal ◽  
Melissa F. Perkal ◽  
Chirag R. Parikh
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Additional Parameter ◽  
Term Survival ◽  
Long Term Survival

1370: EPIDEMIOLOGY AND LONG-TERM SURVIVAL FOR DIFFERENT TRAJECTORIES OF ACUTE KIDNEY INJURY AFTER SEPSIS

2018 ◽  
Vol 46 (1) ◽  
pp. 668-668
Author(s):  
Tezcan Ozrazgat Baslanti ◽  
Zhongkai Wang ◽  
Gabriella Ghita ◽  
Larysa Sautina ◽  
Rajesh Mohandas ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Malnutrition screening and acute kidney injury in hospitalised patients: a retrospective study over a 5-year period from China

2019 ◽  
Vol 123 (3) ◽  
pp. 337-346 ◽  
Author(s):  
Chenyu Li ◽  
Lingyu Xu ◽  
Chen Guan ◽  
Long Zhao ◽  
Congjuan Luo ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Nutritional Status ◽  
Cox Regression ◽  
Kidney Injury ◽  
Nutritional Risk ◽  
Term Survival ◽  
Long Term Survival ◽  
Hospitalised Patients ◽  
Nrs 2002

AbstractMalnutrition and acute kidney injury (AKI) are common complications in hospitalised patients, and both increase mortality; however, the relationship between them is unknown. This is a retrospective propensity score matching study enrolling 46 549 inpatients, aimed to investigate the association between Nutritional Risk Screening 2002 (NRS-2002) and AKI and to assess the ability of NRS-2002 and AKI in predicting prognosis. In total, 37 190 (80 %) and 9359 (20 %) patients had NRS-2002 scores <3 and ≥3, respectively. Patients with NRS-2002 scores ≥3 had longer lengths of stay (12·6 (sd 7·8) v. 10·4 (sd 6·2) d, P < 0·05), higher mortality rates (9·6 v. 2·5 %, P < 0·05) and higher incidence of AKI (28 v. 16 %, P < 0·05) than patients with normal nutritional status. The NRS-2002 showed a strong association with AKI, that is, the risk of AKI changed in parallel with the score of the NRS-2002. In short- and long-term survival, patients with a lower NRS-2002 score or who did not have AKI achieved a significantly lower risk of mortality than those with a high NRS-2002 score or AKI. Univariate Cox regression analyses indicated that both the NRS-2002 and AKI were strongly related to long-term survival (AUC 0·79 and 0·71) and that the combination of the two showed better accuracy (AUC 0·80) than the individual variables. In conclusion, malnutrition can increase the risk of AKI and both AKI and malnutrition can worsen the prognosis that the undernourished patients who develop AKI yield far worse prognosis than patients with normal nutritional status.

scholarly journals Long-term survival for ICU patients with acute kidney injury

Critical Care ◽  
2012 ◽  
Vol 16 (S1) ◽  
Author(s):  
D Scott ◽  
F Cismondi ◽  
J Lee ◽  
T Mandelbaum ◽  
LA Celi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Term Survival ◽  
Icu Patients ◽  
Long Term Survival

scholarly journals SP248THE IMPACT OF PREDICTORS ON THE LONG-TERM SURVIVAL OF DIALYSIS-REQUIRING ACUTE KIDNEY INJURY (AKI) PATIENTS

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii460-iii461
Author(s):  
Jana Uhlinova ◽  
Marek Eerme ◽  
Ülle Pechter ◽  
Mait Raag ◽  
Peeter Tähepõld ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Term Survival ◽  
Long Term Survival

P0602CLINICAL PATTERN, RENAL RECOVERY AND PATIENT OUTCOMES AFTER ACUTE KIDNEY INJURY IN ADULTS IN AN EMERGING COUNTRY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Arunkumar Subbiah ◽  
Sanjay Kumar Agarwal
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Hospitalized Patients ◽  
Renal Recovery ◽  
Common Source ◽  
Partial Recovery

Abstract Background and Aims Acute Kidney Injury (AKI) is an important determinant of outcome in hospitalized patients. Further, there is a risk for development of Chronic Kidney Disease (CKD) in the future. Though the long-term impact of AKI has been studied in developed countries, there is a paucity of data in this area from the Indian subcontinent. This single-centre study aimed to assess the pattern, clinical spectrum, short-term and long-term outcomes of AKI. Method In this prospective observational cohort study, detailed demographic and clinical data at presentation, during hospital stay and follow-up at 1, 3, 6 and 12 months after discharge were obtained prospectively for a cohort of patients with AKI. Both community (CAAKI) and hospital acquired AKI (HAAKI) were included. Patient with pre-existing CKD were excluded. Outcome variables examined were in-hospital mortality, renal function at discharge and on follow-up after discharge from hospital. Results In our study cohort with 476 patients, majority of the cases were CAAKI (395, 83%). The mean age at presentation was 44.8 ± 18.7 years. Medical causes (84%) contributed to the majority of AKI while the remaining were due to surgical (10%) and obstetrical (6%) causes. Sepsis (176/476; 36.9%) was the most common cause of AKI. The most common source for sepsis was respiratory (41%) followed by urological source (18.7%). The in-hospital mortality rate for patients with AKI was 38%. Age &gt;60 years (HR = 1.51; 95% CI, 1.11 – 2.07), oliguria (HR = 1.48; 95% CI, 1.05 – 2.10), need for ventilator (HR = 2.45; 95% CI, 1.36 – 4.41) and/or inotropes (HR = 14.4; 95% CI, 6.28 – 33.05) were predictors of mortality. At discharge, 146 (30.7%) patients had complete renal recovery, while 149 (31.3%) had partial renal recovery. Oliguria (p &lt; 0.001), hypoalbuminemia (p = 0.001) and need for renal replacement therapy (RRT) (p = 0.01) were significantly associated with partial recovery. Of the 295 patients on follow-up at discharge, 211 (71.5%) patients had normal renal function, 4 (1.4%) died and 33 (11.2%) were lost to follow up; 47(15.9%) patients developed CKD of which 6 (2%) were dialysis dependent. Elderly patients, higher AKIN stage with oliguria and those requiring RRT were more likely to develop CKD. Among these, the need for in-hospital RRT was the single most important factor predicting the risk of CKD (OR 1.77, 95% CI, 1.12-2.78). Conclusion In conclusion, our data shows that AKI in hospitalized patients still has high mortality in emerging countries like India. Though a fairly good percentage of cases recovered, there is a definite risk of CKD development, especially in patients who required RRT during hospitalization.

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