Perspectives on acute kidney injury strategy in China

Zhao, Yutong; Yang, Li

doi:10.1111/nep.13458

Cited by 11 publications

(7 citation statements)

References 15 publications

(30 reference statements)

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“…The incidence of S-AKI in LI's paper was only 6.4% 16 . The current literature reported incidence of S-AKI is from 39.4-60.7% in ICU 21,22 , which is consistent with our nding (48%).…”

Section: Discussionsupporting

confidence: 93%

Epidemiology of Sepsis-associated Acute Kidney Injury in Beijing, China : a descriptive analysis

Wang

et al. 2021

Preprint

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Background Sepsis is the most common contributing factor towards development of acute kidney injury (AKI), which is strongly associated to poor prognostic outcomes. There are numerous epidemiological studies about sepsis-associated acute kidney injury (S-AKI), however current literature is limited with the majority of studies being conducted only in the intensive care unit (ICU) setting. The aim of this study was to assess the epidemiology of S-AKI in all hospitalized in-patients.Methods This was a retrospective population-based study using a large regional population database in Beijing city from January, 2005 to December, 2017. It included patients with S-AKI. Patients with pre-existing end-stage kidney disease (ESKD), previous history of kidney transplantation, or being pregnant were excluded. Patients’ demographic characteristics, incidence, risk factors and outcomes of S-AKI were analyzed. The differences between different time periods, different levels of hospitals, and types of the hospitals (i.e. traditional Chinese medicine hospitals (TCMHs) and Western medicine hospitals (WMHs)) were also compared using Mann-Whitney U test.Results A total of 19,579 patients were included. The overall incidence of S-AKI in all in-patients was 48.1%. The risk factors for AKI included: age (P < 0.001), male (P < 0.001), treatment in a level-II hospital (P < 0.001) and so on. The overall mortality rate in this cohort was 55%. The risk factors for mortality included: age (P < 0.001), female (P < 0.001), pre-existing chronic kidney disease (CKD) (P = 0.023) and so on. The incidence of S-AKI increased over time, but the mortality rate did not. Compared with level-II hospitals, the incidence of S-AKI was similar in tertiary hospitals, but the mortality rate was significantly higher.Although patients treated in TCMHs had a shorter hospital stay and a lower cost of care, this cohort had a higher mortality rate when compared with patients treated in WMHs.Conclusions AKI is a common complication in all hospitalized patients with sepsis, and its incidence increases over time, especially when ICU admission is required. Exploring interventional strategies to address modifiable risk factors will be important to reduce incidence and mortality of S-AKI.

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“…The incidence of S-AKI in LI's paper was only 6.4% 16 . The current literature reported incidence of S-AKI is from 39.4-60.7% in ICU 21,22 , which is consistent with our nding (48%).…”

Section: Discussionsupporting

confidence: 93%

Epidemiology of Sepsis-associated Acute Kidney Injury in Beijing, China : a descriptive analysis

Wang

et al. 2021

Preprint

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“… 1–5 The current literature reported incidence of S-AKI is from 39.4% to 60.7% in ICU, which is consistent with our finding (48%). 22 , 23 …”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] The current literature reported incidence of S-AKI is from 39.4% to 60.7% in ICU, which is consistent with our finding (48%). 22,23 According to the nationwide survey regarding AKI across Mainland China, 72% of AKI episodes occurred in the non-ICU setting, which reminds us that the occurrence of AKI outside the ICU requires more attention. 17 Our study showed that certain demographic characteristics, including advanced age, male and the presence of comorbidities such as hypertension, CKD and liver cirrhosis, and severity of the diseases as assessed by requirements for ICU admission and shock status were significantly associated with the incidence of AKI.…”

Section: S-aki Patients In Traditional Chinesementioning

confidence: 99%

Epidemiology of Sepsis-Associated Acute Kidney Injury in Beijing, China: A Descriptive Analysis

Wang¹,

Ji²,

Wang³

et al. 2021

IJGM

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Background Sepsis is the most common contributing factor towards development of acute kidney injury (AKI), which is strongly associated to poor prognostic outcomes. There are numerous epidemiological studies about sepsis-associated acute kidney injury (S-AKI), however current literature is limited with the majority of studies being conducted only in the intensive care unit (ICU) setting. The aim of this study was to assess the epidemiology of S-AKI in all hospitalized in-patients. Methods This was a retrospective population-based study using a large regional population database in Beijing city from January, 2005 to December, 2017. It included patients with S-AKI. Patients with pre-existing end-stage kidney disease (ESKD), previous history of kidney transplantation, or being pregnant were excluded. Patients’ demographic characteristics, incidence, risk factors and outcomes of S-AKI were analyzed. The contrast between different time periods, different levels of hospitals, and types of the hospitals (traditional Chinese medicine hospitals (TCMHs) and western medicine hospitals (WMHs)) was also compared using Mann–Whitney U -test. Results A total of 19,579 patients were included. The overall incidence of S-AKI in all in-patients was 48.1%. The significant risk factors by multivariate analysis for AKI included: age, male, being treated in a level-II hospital, pre-existing hypertension, chronic kidney disease (CKD), cirrhosis, atrial fibrillation (AF), ischemic heart disease (IHD), being admitted from emergency room, ICU admission, shock, pneumonia, intra-abdominal infection, bloodstream infection, respiratory insufficiency, acute liver injury, disseminated intravascular coagulation (DIC) and metabolic encephalopathy. The overall mortality rate in this cohort was 55%. The multivariate analysis showed that the significant risk factors for mortality included: age, being treated in a level-II hospital and TCMHs, being admitted from emergency room, pre-existing comorbidities (CKD, malignancy, cirrhosis and AF), shock, pneumonia, intra-abdominal infection, bloodstream infection, central nervous system (CNS) infection and respiratory insufficiency. Conclusion AKI is a common complication in patients with sepsis, and its incidence increases over time, especially when ICU admission is required. Exploring interventional strategies to address modifiable risk factors will be important to reduce incidence and mortality of S-AKI.

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“…The higher incidence of AKI in our study might be due to frequent creatinine measurements. In this study, 88% of patients had serum creatinine levels measured twice or more, which is much more frequent than the repeated detection rate of 25.3% in China and 63.2-67.6% in developed countries [29]. Therefore, our detection rate is closer to the actual incidence of AKI in older adults in the real world.…”

Section: Discussionmentioning

confidence: 46%

Clinical features, risk factors, and clinical burden of acute kidney injury in older adults

Hao

Chen

et al. 2020

Renal Failure

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Perspectives on acute kidney injury strategy in China

Cited by 11 publications

References 15 publications

Epidemiology of Sepsis-associated Acute Kidney Injury in Beijing, China : a descriptive analysis

Epidemiology of Sepsis-associated Acute Kidney Injury in Beijing, China : a descriptive analysis

Epidemiology of Sepsis-Associated Acute Kidney Injury in Beijing, China: A Descriptive Analysis

Clinical features, risk factors, and clinical burden of acute kidney injury in older adults

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