Long-Term Mortality among Hospitalized Non-ICU Patients with Acute Kidney Injury Referred to Nephrology

Abstract

Background: Epidemiological studies of acute kidney injury (AKI) have focused on patients admitted to intensive care units (ICUs), and several have studied hospitalized non-ICU patients, but analysis of patients referred to Nephrology is sparse. We analyzed factors associated with short- and long-term morbimortality among hospitalized non-ICU patients with AKI who were referred to Nephrology. Methods: A retrospective study with data prospectively collected from 170 non-ICU patients, with referral to the Nephrology Unit, recruited over a 4-year period, was performed. AKI was classified according to the criteria based on risk, injury, failure, loss of kidney function and end-stage kidney disease (RIFLE). Risk factors that could influence prognosis of AKI and long-term mortality were analyzed at admission. Early on, 1- and 10-year mortalities were correlated with AKI RIFLE class, clinical and demographic characteristics. Results: Most patients were >65 years, with multiple comorbidities and frequent drug intake history. Median Charlson score was 6. Twenty-five percent of patients with previously unknown chronic kidney disease (CKD) were diagnosed with CKD during the study. Dialysis was required in 13.5% of patients. Hospital deaths were 22.4% and significantly associated with older age, RIFLE class L, higher peak serum creatinine, oliguria and decreased serum albumin levels. One-year (38.8%) and 10-year (68.8%) mortalities were significantly associated with age, prior cardiovascular disease, prior CKD and RIFLE class L. According to the Cox proportional hazard model, age, prior CKD and RIFLE class L were independent risk factors of death at 1 and 10 years. Conclusions: AKI in hospitalized non-ICU patients is associated with high early and late mortality. This study increases our understanding of AKI among this specific population and can improve their management.

Urinary Kininogen-1 and Retinol binding protein-4 respond to Acute Kidney Injury: predictors of patient prognosis?

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Early Impact on Renal Parenchymal Vascularization of Chimney Grafts Versus Fenestrated Grafts

“…Very few series have described the impact of such procedures on renal function, despite acute renal failure following complex EVAR being a common complication with a risk of progression towards permanent renal impairment, or even early or long-term mortality. 19,20 The advantage of one technique over the other is still unclear because of the scarcity of reports comparing both techniques. 21e24 More importantly the impact of these revascularization modes on renal function is poorly described, and the lack of universal standardized definitions makes comparison of results more difficult.…”

Development and Validation of a Nomogram for Predicting Drug-Induced Acute Kidney Injury in Hospitalized Patients: A Case-Control Study Based on Propensity-Score Matching

“…Acute kidney injury (AKI) is one of the most serious complications of hospitalized patients, and is associated with increased risk of death and higher costs ( Ruiz-Criado et al, 2015 ; Sykes et al, 2018 ). Drugs have become the third to fifth leading cause of AKI in hospitalized patients ( Kane-Gill and Goldstein, 2015 ).…”