https://scholars.lib.ntu.edu.tw/handle/123456789/474223
標題: | Kidney function decline after a non-dialysis-requiring acute kidney injury is associated with higher long-term mortality in critically ill survivors | 作者: | CHUN-FU LAI VIN-CENT WU TAO-MIN HUANG YU-CHANG YEH KUO-CHUAN WANG YIN-YI HAN YU-FENG LIN Jhuang Y.-J. CHIA-TER CHAO Shiao C.-C. Tsai P.-R. Hu F.-C. NAI-KUAN CHOU Ko W.-J. KWAN-DUN WU |
公開日期: | 2012 | 卷: | 16 | 期: | 4 | 來源出版物: | Critical Care | 摘要: | Introduction: The adverse consequences of a non-dialysis-requiring acute kidney injury (AKI) are unclear. This study aimed to assess the long-term prognoses for critically ill patients experiencing a non-dialysis-requiring AKI.Methods: This retrospective observational cohort study investigated non-dialysis-requiring AKI survivors in surgical intensive care units between January 2002 and June 2010. All longitudinal post-discharge serum creatinine measurements and information regarding end-stage renal disease (ESRD) and death were collected. We assessed the long-term outcomes of chronic kidney disease (CKD), ESRD and all-cause mortality beyond discharge.Results: Of the 922 identified critically ill patients with a non-dialysis-requiring AKI, 634 (68.8%) patients who survived to discharge were enrolled. A total of 207 patients died after a median follow-up of 700.5 days. The median intervals between the onset of the AKI and the composite endpoints "stage 3 CKD or death", "stage 4 CKD or death", "stage 5 CKD or death", and "ESRD or death" were 685, 1319, 1743, and 2048 days, respectively. This finding shows a steady long-term decline in kidney function after discharge. Using the multivariate Cox proportional hazard model, we found that every 1 mL/min/1.73 m 2decrease from baseline estimated glomerular filtration rate (eGFR) of individuals who progressed to stage 3, 4, and 5 CKD increased the risks of long-term mortality by 0.7%, 2.3%, and 4.1%, respectively (all p < 0.05). This result indicates that the mortality risk increased significantly in a graded manner as kidney function declined from the baseline eGFR to advanced stages of CKD during the follow-up period.Conclusions: In critically ill patients who survive a non-dialysis-requiring AKI, there is a need for continuous monitoring and kidney function protection beyond discharge. ? 2012 Lai et al.; licensee BioMed Central Ltd. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84863702457&doi=10.1186%2fcc11419&partnerID=40&md5=4f75dd29bb7d4b054c102325f9efb49d https://scholars.lib.ntu.edu.tw/handle/123456789/474223 |
ISSN: | 1364-8535 | DOI: | 10.1186/cc11419 | SDG/關鍵字: | creatinine; creatinine; acute kidney failure; adolescent; adult; aged; article; chronic kidney disease; cohort analysis; creatinine blood level; critically ill patient; female; follow up; glomerulus filtration rate; hospital discharge; human; intensive care unit; kidney dysfunction; kidney failure; longitudinal study; major clinical study; male; mortality; non dialysis requiring acute kidney injury; observational study; outcome assessment; priority journal; prognosis; proportional hazards model; retrospective study; risk factor; survivor; Acute Kidney Injury; blood; comorbidity; critical illness; disease course; hospital mortality; Kidney Failure, Chronic; kidney function test; middle aged; pathophysiology; survival analysis; Taiwan; treatment outcome; very elderly; Acute Kidney Injury; Adolescent; Adult; Aged; Aged, 80 and over; Comorbidity; Creatinine; Critical Illness; Disease Progression; Female; Hospital Mortality; Humans; Intensive Care Units; Kidney Failure, Chronic; Kidney Function Tests; Male; Middle Aged; Retrospective Studies; Survival Analysis; Survivors; Taiwan; Treatment Outcome |
顯示於: | 醫學系 |
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