Persistent kidney dysfunction after acute kidney injury predicts short‐term outpatient mortality

Abstract

Background: Acute kidney injury (AKI) during hospitalisation is frequent and associated with adverse outcomes.Aims: To evaluate the association between renal function recovery after AKI and short-term post-discharge mortality.Methods: This is a retrospective study of all AKI episodes codified in the electronic records of a single centre in 2013 and 2014. Epidemiological data and comorbidities at baseline and laboratory values at admission and discharge were collected. Persistent kidney dysfunction after AKI was defined as a last serum creatinine equal or above 1.2-fold over baseline level. Patients were followed for 30 days after discharge.Results: Out of 1720 evaluated patients, 1541 (89%) were analysed. Of them, 869 (56%) recovered renal function. Independent predictors of renal function recovery after AKI were lower baseline estimated glomerular filtration rate (eGFR) (P < 0.001), higher admission eGFR (P < 0.001) and haemoglobin (P = 0.016), milder AKI (P = 0.037), absence of a history of heart failure (P < 0.001) and lower admission blood pressure (P < 0.001). After discharge, 46 (3%) patients died in the first 30 days. Persistent kidney dysfunction was associated (P = 0.01) with and independently predicted (odds ratio 2.6; 95% confidence interval 1.2-5.4; P = 0.01) short-term post-discharge mortality.Conclusions: Persistent kidney dysfunction after an AKI episode is an independent predictor of 30-day post-discharge mortality. This information might help select AKI patients who require closer follow up and monitoring after discharge.

The impact of transient and persistent acute kidney injury in hospital mortality in COVID-19 patients

“…None of the previously mentioned studies evaluated persistent AKI in mortality. According to previous studies in patients without COVID-19, persistent AKI affected mortality 36 - 38 . To date, we are not aware of any study that evaluated the real impact of AKI duration on vital prognosis of COVID-19 patients.…”

Global Perspectives in Acute Kidney Injury: Spain

“…The authors described an increased mortality at 30 days of discharge in the group with persistent chronic kidney dysfunction (6.5% versus 2.8%). 20 Those survivors with severe AKI who required RRT are usually known by nephrology units and subsequently followed. However, a lot of patients get lost, and general practitioners are responsible of their follow-up, in many cases without knowing the history of a previous episode of AKI.…”

“…The authors described an increased mortality at 30 days of discharge in the group with persistent chronic kidney dysfunction (6.5% versus 2.8%). 20 …”

“… Hospital-acquired AKI and survival in a single tertiary center in Spain. Adapted from Quiroga et al 20 …”

Association between nutritional status scores and the 30-day mortality in patients with acute kidney injury: an analysis of MIMIC-III database

“…Acute kidney injury (AKI) is defined by a sudden dysfunction of the kidney, and the in-hospital mortality of AKI is as high as 50% overall [ 1 , 2 ]. AKI is related to adverse metabolic and nutritional outcomes such as metabolic abnormalities of protein and fat, inducing proinflammatory state and immune ability impairment [ 3 ]. The possible effects of nutritional conditions, substrate balance, and treatment processes cannot be neglected in hospitalization of patients with AKI [ 4 ].…”