Acute kidney injury on hospital admission tied to poor outcomes after discharge

Reuters Health - 12/11/2021 - Hospital admission with a diagnosis of acute kidney injury (AKI) is an independent risk factor for multiple adverse patient outcomes within three months and one year after discharge, according to a new study.

"These findings highlight the need for early interventions to mitigate the significant morbidity and mortality burden associated with an AKI event in patients with and without chronic kidney disease (CKD)," study chief Dr. Ivonne H. Schulman of the National Institutes of Health told attendees at the American Society of Nephrology (ASN) Kidney Week, where she presented the study.

Using a large U.S. database of claims and laboratory data, the researchers matched more than 594,000 patients hospitalized with AKI and an equal number of patients hospitalized without AKI. In both cohorts, the mean age was 74 years and roughly half had pre-existing CKD.

The researchers found a higher cumulative incidence of re-admission due to any cause and death from the time of discharge to 90 days and one year after discharge in patients with a first AKI event, with or without pre-existing CKD, compared with matched patients without AKI, with or without CKD.

Sepsis, heart failure and recurrent AKI were the primary causes of re-admission with the highest cumulative incidence at 90 days and one year in AKI patients and were significantly more common in patients with than without AKI, Dr. Schulman reported.

With AKI, the risk of all-cause mortality was stronger at 90 days than at one year (hazard ratio, 3.04 and 2.39).

"While the best post-AKI clinical management regimen is yet to be determined, these results underscore the immediate need for close post-hospitalization monitoring of individuals with AKI," Dr. Schulman told attendees.

SOURCE: https://bit.ly/3CUIO6m Kidney Week 2021, held November 4-7, 2021.

By Megan Brooks



Posted on 12 November 202116 November 2021