Determinants of Outcomes of Acute Kidney Injury: Clinical Predictors and Beyond

Abdel‐Rahman, Emaad M.; Turgut, Faruk; Gautam, Jitendra; Gautam, Samir C.

doi:10.3390/jcm10061175

Cited by 11 publications

(10 citation statements)

References 111 publications

(153 reference statements)

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“…Based on the results of Cox model analysis, patients in high altitude experienced a lower cumulative probability of kidney recovery compared with those in low altitude (P < 0.001). The kidney of AKI, unlike chronic kidney disease (CKD), may be resolved to some extent, though the course may range from several days to years [1,39]. A prospective cohort study proved that early recovery of kidney function was closely linked to better longterm outcomes of AKI-D [40].…”

Section: Discussionmentioning

confidence: 99%

The Benefits of Early Continuous Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury at High-Altitude Areas: A Retrospective Multi-center Cohort Study

Wang

Peng

Wei

et al. 2023

Preprint

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Severe hypoxia would aggravate the acute kidney injure (AKI) in high-altitude areas and continuous renal replacement therapy (CRRT) has been used to treat critically ill patients with AKI. However, the characteristics and outcomes of CRRT of critically ill patients with AKI in high altitude and the optimal timing of CRRT initiation are still unclear. 1,124 patients were diagnosed with AKI and treated with CRRT in ICU, involving high-altitude group (n = 648) and low-altitude group (n = 476). Compared with low-altitude group, patients with AKI in high altitude showed longer CRRT (4.8 vs. 3.7, P = 0.036) and more rapid progression of AKI stages (P < 0.01), but without any significance of minor or major bleeding episode (P > 0.05). Referring to the analysis of survival and kidney recovery curves, a higher mortality but a lower possibility of renal recovery was observed in high-altitude group (P < 0.001). However, in the high-altitude group, the survival rate of early CRRT initiation was significantly higher than that of delayed CRRT initiation (P < 0.001). The findings showed poorer clinical outcomes of patients undergoing CRRT for AKI in high altitude. CRRT at high altitude was unlikely to increase the adverse events. Moreover, early CRRT initiation might reduce the mortality and promote renal recovery in high-altitude patients.

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Section: Discussionmentioning

confidence: 99%

The Benefits of Early Continuous Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury at High-Altitude Areas: A Retrospective Multi-center Cohort Study

Wang

Peng

Wei

et al. 2023

Preprint

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“…A follow-up with a multidisciplinary team that includes a nephrologist, primary care provider (PCP), pharmacist, and nutritionist should be recommended with adequate communication among members of the team for all AKI patients, especially those patients who are at high risk for recurrent AKI, worsening kidney function, or cardiac complications. Monitoring for predictors of outcomes of AKI needs to be routinely done in the outpatient setting [ 33 ].…”

Section: Care For Aki Survivors: ( Table 1 )mentioning

confidence: 99%

Optimum Post-Discharge Care of Acute Kidney Injury (AKI) Survivors

Alwagdani

Awad

Abdel‐Rahman

2022

JCM

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Acute kidney injury (AKI) is a serious problem, affecting multiple organs, and is associated with a high mortality. The severe consequences of AKI extend beyond hospital discharge to the outpatient setting. While a plethora of literature exists guiding the management of AKI in the hospital setting, currently, there are no guidelines for the best care of AKI patients post-hospital discharge. In this review, we address the burden of AKI on patients and the importance of optimal coordinated care of these patients post-hospital discharge. We review the care of patients with or without dialysis requirements at the time of discharge and thereafter.

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“…Patients with AKI-D discharged from hospital to an outpatient hemodialysis setting may recover to become dialysis-independent, or may continue to have long-term renal complications which require prolonged dialysis [ 9 , 10 , 11 ], end stage kidney diseases (ESKD), or even death [ 5 , 6 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…While multiple demographic and comorbid variables were identified as predictors of AKI-D outcome, many of these parameters are non-modifiable [ 9 , 10 , 13 , 16 , 17 ]. Modifiable factors that may play a role in predicting and hence promoting better care of AKI-D include the dialysis prescription and the dialysis procedure in the outpatient setting.…”

Section: Introductionmentioning

confidence: 99%

Association of Intradialytic Hypotension and Ultrafiltration with AKI-D Outcomes in the Outpatient Dialysis Setting

Abdel‐Rahman

Casimir

Lyons

et al. 2022

JCM

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Identifying modifiable predictors of outcomes for cases of acute kidney injury requiring hemodialysis (AKI-D) will allow better care of patients with AKI-D. All patients with AKI-D discharged to University of Virginia (UVA) outpatient HD units between 1 January 2017 to 31 December 2019 (n = 273) were followed- for up to six months. Dialysis-related parameters were measured during the first 4 weeks of outpatient HD to test the hypothesis that modifiable factors during dialysis are associated with AKI-D outcomes of recovery, End Stage Kidney Disease (ESKD), or death. Patients were 42% female, 67% Caucasian, with mean age 62.8 ± 15.4 years. Median number of dialysis sessions was 11 (6–15), lasting 3.6 ± 0.6 h. At 90 days after starting outpatient HD, 45% recovered, 45% were declared ESKD and 9.9% died, with no significant changes noted between three and six months. Patients who recovered, died or were declared ESKD experienced an average of 9, 10 and 16 intradialytic hypotensive (IDH) episodes, respectively. More frequent IDH episodes were associated with increased risk of ESKD (p = 0.01). A one liter increment in net ultrafiltration was associated with 54% increased ratio of ESKD (p = 0.048). Optimizing dialysis prescription to decrease frequency of IDH episodes and minimize UF, and close monitoring of outpatient dialysis for patients with AKI-D, are crucial and may improve outcomes for these patients.

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Determinants of Outcomes of Acute Kidney Injury: Clinical Predictors and Beyond

Cited by 11 publications

References 111 publications

The Benefits of Early Continuous Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury at High-Altitude Areas: A Retrospective Multi-center Cohort Study

The Benefits of Early Continuous Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury at High-Altitude Areas: A Retrospective Multi-center Cohort Study

Optimum Post-Discharge Care of Acute Kidney Injury (AKI) Survivors

Association of Intradialytic Hypotension and Ultrafiltration with AKI-D Outcomes in the Outpatient Dialysis Setting

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