The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Relationship between duration of hospital-acquired acute kidney injury and mortality: a prospective observational study

  • Yoo, Jinyoung (Division of Nephrology, Soonchunhyang University Hospital) ;
  • Lee, Ji Sung (Biostatistical Consulting Unit, Soonchunhyang University Hospital) ;
  • Lee, Jiyeon (Division of Nephrology, Soonchunhyang University Hospital) ;
  • Jeon, Jin Seok (Division of Nephrology, Soonchunhyang University Hospital) ;
  • Noh, Hyunjin (Division of Nephrology, Soonchunhyang University Hospital) ;
  • Han, Dong Cheol (Division of Nephrology, Soonchunhyang University Hospital) ;
  • Kwon, Soon Hyo (Division of Nephrology, Soonchunhyang University Hospital)
  • Received : 2014.04.29
  • Accepted : 2014.06.30
  • Published : 2015.03.01
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Abstract

Background/Aims: New definitions of acute kidney injury (AKI) have recently emerged. Some studies have suggested that duration of AKI is an additional predictive parameter for mortality. Here, we evaluated whether AKI duration was predictive of long-term mortality in patients with hospital-acquired acute kidney injury (HAAKI). Methods: We prospectively enrolled patients who developed HAAKI at an urban university hospital, from September 2007 to August 2008 and followed them until December 2011. Patients were divided into two groups by duration of the AKI (1 to 5 days vs. ${\geq}6days$), and long-term mortality was compared. Results: HAAKI developed in 1.2% of patients during the enrollment period. The median follow-up period was 240 days (interquartile range, 53 to 1,428). In 42.3% of patients (n = 52), the AKI lasted 1 to 5 days, while it lasted ${\geq}6days$ in 57.7% (n = 71). Survival analysis showed that a longer duration of AKI increased the risk of death. Long-term survival was significantly different in the two groups. Conclusions: The duration of AKI influenced mortality rates in hospitalized patients. Thus, AKI duration is a parameter affecting mortality in HAAKI.

Keywords

Acknowledgement

Supported by : Soonchunhyang University

References

  1. Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol 2005;16:3365-3370. https://doi.org/10.1681/ASN.2004090740
  2. Liangos O, Wald R, O'Bell JW, Price L, Pereira BJ, Jaber BL. Epidemiology and outcomes of acute renal failure in hospitalized patients: a national survey. Clin J Am Soc Nephrol 2006;1:43-51.
  3. Morgera S, Schneider M, Neumayer HH. Long-term outcomes after acute kidney injury. Crit Care Med 2008;36(4 Suppl):S193-S197. https://doi.org/10.1097/CCM.0b013e318168cae2
  4. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39:930-936. https://doi.org/10.1053/ajkd.2002.32766
  5. Clermont G, Acker CG, Angus DC, Sirio CA, Pinsky MR, Johnson JP. Renal failure in the ICU: comparison of the impact of acute renal failure and end-stage renal disease on ICU outcomes. Kidney Int 2002;62:986-996. https://doi.org/10.1046/j.1523-1755.2002.00509.x
  6. Bagshaw SM, Mortis G, Doig CJ, Godinez-Luna T, Fick GH, Laupland KB. One-year mortality in critically ill patients by severity of kidney dysfunction: a population-based assessment. Am J Kidney Dis 2006;48:402-409. https://doi.org/10.1053/j.ajkd.2006.06.002
  7. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P; Acute Dialysis Quality Initiative workgroup. Acute renal failure: definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8:R204-R212. https://doi.org/10.1186/cc2872
  8. Mehta RL, Kellum JA, Shah SV, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11:R31. https://doi.org/10.1186/cc5713
  9. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Section 2: AKI definition. Kidney Int Suppl 2012;2:19-36. https://doi.org/10.1038/kisup.2011.32
  10. Hoste EA, Clermont G, Kersten A, et al. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care 2006;10:R73. https://doi.org/10.1186/cc4915
  11. Uchino S, Bellomo R, Goldsmith D, Bates S, Ronco C. An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med 2006;34:1913-1917. https://doi.org/10.1097/01.CCM.0000224227.70642.4F
  12. Ricci Z, Cruz D, Ronco C. The RIFLE criteria and mortality in acute kidney injury: a systematic review. Kidney Int 2008;73:538-546. https://doi.org/10.1038/sj.ki.5002743
  13. Kwon SH, Noh H, Jeon JS, Kim Y, Han DC. An assessment of AKIN criteria for hospital-acquired acute kidney injury: a prospective observational cohort study. Nephron Clin Pract 2010;116:c217-c223. https://doi.org/10.1159/000317202
  14. Ostermann M, Chang RW. Acute kidney injury in the intensive care unit according to RIFLE. Crit Care Med 2007;35:1837-1843. https://doi.org/10.1097/01.CCM.0000277041.13090.0A
  15. Brown JR, Kramer RS, Coca SG, Parikh CR. Duration of acute kidney injury impacts long-term survival after cardiac surgery. Ann Thorac Surg 2010;90:1142-1148. https://doi.org/10.1016/j.athoracsur.2010.04.039
  16. Coca SG, King JT Jr, Rosenthal RA, Perkal MF, Parikh CR. The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans. Kidney Int 2010;78:926-933. https://doi.org/10.1038/ki.2010.259
  17. Han SS, Kim S, Ahn SY, et al. Duration of acute kidney injury and mortality in critically ill patients: a retrospective observational study. BMC Nephrol 2013;14:133. https://doi.org/10.1186/1471-2369-14-133
  18. Uchino S, Bellomo R, Bagshaw SM, Goldsmith D. Transient azotaemia is associated with a high risk of death in hospitalized patients. Nephrol Dial Transplant 2010;25:1833-1839. https://doi.org/10.1093/ndt/gfp624
  19. Wang HE, Muntner P, Chertow GM, Warnock DG. Acute kidney injury and mortality in hospitalized patients. Am J Nephrol 2012;35:349-355. https://doi.org/10.1159/000337487
  20. Meier P, Bonfils RM, Vogt B, Burnand B, Burnier M. Referral patterns and outcomes in noncritically ill patients with hospital-acquired acute kidney injury. Clin J Am Soc Nephrol 2011;6:2215-2225. https://doi.org/10.2215/CJN.01880211
  21. Hou SH, Bushinsky DA, Wish JB, Cohen JJ, Harrington JT. Hospital-acquired renal insufficiency: a prospective study. Am J Med 1983;74:243-248. https://doi.org/10.1016/0002-9343(83)90618-6
  22. Singh TB, Rathore SS, Choudhury TA, Shukla VK, Singh DK, Prakash J. Hospital-acquired acute kidney injury in medical, surgical, and intensive care unit: a comparative study. Indian J Nephrol 2013;23:24-29. https://doi.org/10.4103/0971-4065.107192
  23. D'Hoore W, Sicotte C, Tilquin C. Risk adjustment in outcome assessment: the Charlson comorbidity index. Methods Inf Med 1993;32:382-387. https://doi.org/10.1055/s-0038-1634956
  24. Wen J, Cheng Q, Zhao J, et al. Hospital-acquired acute kidney injury in Chinese very elderly persons. J Nephrol 2013;26:572-579. https://doi.org/10.5301/jn.5000182
  25. Tian J, Barrantes F, Amoateng-Adjepong Y, Manthous CA. Rapid reversal of acute kidney injury and hospital outcomes: a retrospective cohort study. Am J Kidney Dis 2009;53:974-981. https://doi.org/10.1053/j.ajkd.2009.02.007
  26. Lopes JA, Fernandes P, Jorge S, et al. Acute kidney injury in intensive care unit patients: a comparison between the RIFLE and the Acute Kidney Injury Network classifications. Crit Care 2008;12:R110. https://doi.org/10.1186/cc6997
  27. Peake M, Whiting M. Measurement of serum creatinine: current status and future goals. Clin Biochem Rev 2006;27:173-184.
  28. Fujii T, Uchino S, Takinami M, Bellomo R. Validation of the Kidney Disease Improving Global Outcomes criteria for AKI and comparison of three criteria in hospitalized patients. Clin J Am Soc Nephrol 2014;9:848-854. https://doi.org/10.2215/CJN.09530913

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