Medline ® Abstract for Reference 24
of 'Kidney and patient outcomes after acute kidney injury in adults'
Increased risk of death and de novo chronic kidney disease following reversible acute kidney injury.
Bucaloiu ID, Kirchner HL, Norfolk ER, Hartle JE 2nd, Perkins RM
Kidney Int. 2012 Mar;81(5):477-85. Epub 2011 Dec 07.
Acute kidney injury increases mortality risk among those with established chronic kidney disease. In this study we used a propensity score-matched cohort method to retrospectively evaluate the risks of death and de novo chronic kidney disease after reversible, hospital-associated acute kidney injury among patients with normal pre-hospitalization kidney function. Of 30,207 discharged patients alive at 90 days, 1610 with reversible acute kidney injury that resolved within the 90 days were successfully matched across multiple parameters with 3652 control patients who had not experienced acute kidney injury. Median follow-up was 3.3 and 3.4 years (injured and control groups, respectively). In Cox proportional hazard models, the risk of death associated with reversible acute kidney injury was significant (hazard ratio 1.50); however, adjustment for the development of chronic kidney injury during follow-up attenuated this risk (hazard ratio 1.18). Reversible acute kidney injury was associated with a significant risk of de novo chronic kidney disease (hazard ratio 1.91). Thus, a resolved episode of hospital-associated acute kidney injury has important implications for the longitudinal surveillance of patients without preexisting, clinically evident kidney disease.
Department of Nephrology, Geisinger Medical Center, Danville, Pennsylvania, USA.