scholarly journals Kidney function decline after a non-dialysis-requiring acute kidney injury is associated with higher long-term mortality in critically ill survivors

Critical Care ◽  
2012 ◽  
Vol 16 (4) ◽  
pp. R123 ◽  
Author(s):  
Chun-Fu Lai ◽  
Vin-Cent Wu ◽  
Tao-Min Huang ◽  
Yu-Chang Yeh ◽  
Kuo-Chuan Wang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Kidney Function ◽  
Kidney Injury ◽  
Kidney Function Decline ◽  
Long Term Mortality

scholarly journals Anemia Is a Risk Factor for Acute Kidney Injury and Long-Term Mortality in Critically Ill Patients

2015 ◽  
Vol 237 (4) ◽  
pp. 287-295 ◽  
Author(s):  
Seung Seok Han ◽  
Seon Ha Baek ◽  
Shin Young Ahn ◽  
Ho Jun Chin ◽  
Ki Young Na ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Long Term Mortality

scholarly journals Evolution of chronic renal impairment and long-term mortality after de novo acute kidney injury in the critically ill; a Swedish multi-centre cohort study

Critical Care ◽  
2015 ◽  
Vol 19 (1) ◽  
Author(s):  
Claire Rimes-Stigare ◽  
Paolo Frumento ◽  
Matteo Bottai ◽  
Johan Mårtensson ◽  
Claes-Roland Martling ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Renal Impairment ◽  
Critically Ill ◽  
De Novo ◽  
Kidney Injury ◽  
Chronic Renal Impairment ◽  
Long Term Mortality

scholarly journals P0564INCIDENCE AND PROGNOSIS OF ACUTE KIDNEY INJURY VERSUS ACUTE KIDNEY DISEASE AMONG 71,041 INPATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Chenyu Li ◽  
Long Zhao ◽  
Lingyu Xu ◽  
Chen Guan ◽  
Zhibo Zhao ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Renal Impairment ◽  
Kidney Function ◽  
De Novo ◽  
Kidney Injury ◽  
Acute Kidney Disease ◽  
Long Term Mortality

Abstract Background and Aims The current diagnostic criteria for acute kidney injury (AKI) predict the need for dialysis and early mortality, but are less useful to predict long-term outcomes. Acute kidney disease (AKD) defines patients with AKI or subacute loss of kidney function lasting for more than 7 days, which should predict better subsequent chronic kidney disease (CKD). The aim of this study was to investigate the risk factors and prognosis of AKD and to compare different types of acute/subacute renal impairment among Chinese inpatients. Method From a cohort of 450,000 patients consecutive admitted from June 1, 2012, to March 31, 2018 to five district hospitals, complete data were available from 71,041 inpatients. AKI and AKD were diagnosed based on the Acute Disease Quality Initiative Criteria 2017. Based on this diagnostic criterion of AKI and AKD, patients were classified as having (1) AKI Recover, if Scr back to baseline value within 7 days (renal impairment duration of less than 7 days or rapid recovery within 7 days), and (2) AKD with AKI, if a condition in which stage 1 or greater AKI was present ≥ 7 days after an AKI initiating event (continuous AKI progressing to AKD), (3) AKD without AKI, if Scr levels increased slowly but lasted more than 7 days (subacute AKD without meeting the AKI criterion). Results Of 71,041 inpatients, 16,098 (22.66%) patients developed AKI or AKD. 5,895 (8.30%) AKI patients recovered within 7 days (AKI Recover), 5,623 (7.91%) were followed by AKD and 4,580 (6.44%) patients developed AKD without AKI. Thus, AKI and AKD are frequent complications in Chinese inpatients (Fig 1). Compared to AKI recover or AKD without AKI, patients with AKI followed by AKD had higher hospital mortality (16.59% vs. 3.82% vs. 2.12%, P<0.05) and more de novo CKD (8.95% vs. 7.29% vs. 5.48%, P<0.05). Mortality was proportional to stages of AKI and AKD (P for trend <0.05), while AKI followed by AKD was associated with a higher risk of long-term mortality (hazard ratio (HR) 4.51, 4.32-4.71, P<0.05) as compared to AKD without AKI (HR 2.25, 2.13-2.39, P<0.05) and AKI Recover (HR 1.18, 1.09-1.26, P<0.05). The AKI criterion yielded a higher risk for overall survival and a lower risk for de novo CKD than the AKD criterion, indicating that both criteria imply persistent kidney damage but that a rapid decline in excretory kidney function implies higher mortality risks while a persistent decline may rather result in de novo CKD (Fig 2). Meanwhile, these associations between different kidney injury criteria and outcomes had good generalizability and were constant across different genders, surgeries, and comorbidities (Fig 2). The AKD criterion was robustly associated with overall survival (area under the receiver operating characteristic curve (AUROC) 0.71) and de novo CKD (AUROC 0.71), while AKI criterion showed a relatively lower ability to fitting risk of overall survival (AUROC 0.65, P<0.05) and CKD (AUROC 0.63, P<0.05). Moreover, combining AKI and AKD was strongly associated with long-term mortality (AUROC 0.725) and de novo CKD (AUROC 0.72) compared to each single criterion of AKI or AKD (Fig 3). Conclusion (1) Adding AKD as a definition for renal failure lasting >7 days up to 90 days is of clinical importance in addition to the existing definitions for AKI and CKD. (2) These findings suggest research activities and clinical practice should also focus on AKD, which is far more accurate to predict subsequent de novo CKD.

scholarly journals Impact of acute kidney injury on long-term mortality and progression to chronic kidney disease among critically ill children

2017 ◽  
Vol 38 (2) ◽  
pp. 138-142 ◽  
Author(s):  
Najlaa Al-Otaibi ◽  
Maryam Zeinelabdin ◽  
Mohamed Shalaby ◽  
Norah Khathlan ◽  
Ghadi Mashat ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Critically Ill ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Long Term Mortality

scholarly journals Assessment of Kidney Function After Transcatheter Aortic Valve Replacement

2021 ◽  
Vol 8 ◽  
pp. 205435812110180
Author(s):  
Orit Kliuk-Ben Bassat ◽  
Sapir Sadon ◽  
Svetlana Sirota ◽  
Arie Steinvil ◽  
Maayan Konigstein ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Function ◽  
Transcatheter Aortic Valve Replacement ◽  
Kidney Injury ◽  
Single Center ◽  
Transcatheter Aortic Valve ◽  
Single Center Study ◽  
Center Study

Background: Transcatheter aortic valve replacement (TAVR), although associated with an increased risk for acute kidney injury (AKI), may also result in improvement in renal function. Objective: The aim of this study is to evaluate the magnitude of kidney function improvement (KFI) after TAVR and to assess its significance on long-term mortality. Design: This is a prospective single center study. Setting: The study was conducted in cardiology department, interventional unit, in a tertiary hospital. Patients: The cohort included 1321 patients who underwent TAVR. Measurements: Serum creatinine level was measured at baseline, before the procedure, and over the next 7 days or until discharge. Methods: Kidney function improvement was defined as the mirror image of AKI, a reduction in pre-procedural to post-procedural minimal creatinine of more than 0.3 mg/dL, or a ratio of post-procedural minimal creatinine to pre-procedural creatinine of less than 0.66, up to 7 days after the procedure. Patients were categorized and compared for clinical endpoints according to post-procedural renal function change into 3 groups: KFI, AKI, or preserved kidney function (PKF). The primary endpoint was long-term all-cause mortality. Results: The incidence of KFI was 5%. In 55 out of 66 patients patients, the improvement in kidney function was minor and of unclear clinical significance. Acute kidney injury occurred in 19.1%. Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 was a predictor of KFI after multivariable analysis (odds ratio = 0.93 to develop KFI; confidence interval [95% CI]: 0.91-0.95, P < .001). Patients in the KFI group had a higher Society of Thoracic Surgery (STS) score than other groups. Mortality rate did not differ between KFI group and PKF group (43.9% in KFI group and 33.8% in PKF group) but was significantly higher in the AKI group (60.7%, P < .001). Limitations: The following are the limitations: heterozygous definitions of KFI within different studies and a single center study. Although data were collected prospectively, analysis plan was defined after data collection. Conclusions: Improvement in kidney function following TAVR was not a common phenomenon in our cohort and did not reduce overall mortality rate.

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