https://scholars.lib.ntu.edu.tw/handle/123456789/512501
Title: | Acute-on-chronic kidney injury at hospital discharge is associated with long-term dialysis and mortality | Authors: | VIN-CENT WU TAO-MIN HUANG CHUN-FU LAI Shiao C.-C. YU-FENG LIN TZONG-SHINN CHU Wu P.-C. CHIA-TER CHAO JANN-YUAN WANG Kao T.-W. Young G.-H. Tsai P.-R. Tsai H.-B. Wang C.-L. Wu M.-S. WEN-CHIH CHIANG I-JUNG TSAI Hu F.-C. SHUEI-LIONG LIN YUNG-MING CHEN TUN-JUN TSAI Ko W.-J. KWAN-DUN WU |
Issue Date: | 2011 | Publisher: | Nature Publishing Group | Journal Volume: | 80 | Journal Issue: | 11 | Start page/Pages: | 1222-1230 | Source: | Kidney International | Abstract: | Existing chronic kidney disease (CKD) is among the most potent predictors of postoperative acute kidney injury (AKI). Here we quantified this risk in a multicenter, observational study of 9425 patients who survived to hospital discharge after major surgery. CKD was defined as a baseline estimated glomerular filtration rate <45 ml/min per 1.73 m2. AKI was stratified according to the maximum simplified RIFLE classification at hospitalization and unresolved AKI defined as a persistent increase in serum creatinine of more than half above the baseline or the need for dialysis at discharge. A Cox proportional hazard model showed that patients with AKI-on-CKD during hospitalization had significantly worse long-term survival over a median follow-up of 4.8 years (hazard ratio, 3.3) than patients with AKI but without CKD. The incidence of long-term dialysis was 22.4 and 0.17 per 100 person-years among patients with and without existing CKD, respectively. The adjusted hazard ratio for long-term dialysis in patients with AKI-on-CKD was 19.8 compared to patients who developed AKI without existing CKD. Furthermore, AKI-on-CKD but without kidney recovery at discharge had a worse outcome (hazard ratios of 4.6 and 213, respectively) for mortality and long-term dialysis as compared to patients without CKD or AKI. Thus, in a large cohort of postoperative patients who developed AKI, those with existing CKD were at higher risk for long-term mortality and dialysis after hospital discharge than those without. These outcomes were significantly worse in those with unresolved AKI at discharge. ? 2011 International Society of Nephrology. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-81155150125&doi=10.1038%2fki.2011.259&partnerID=40&md5=dc06cf6585a6f93c8394d0a34babe846 https://scholars.lib.ntu.edu.tw/handle/123456789/512501 |
ISSN: | 0085-2538 | DOI: | 10.1038/ki.2011.259 | SDG/Keyword: | creatinine; acute kidney failure; adult; aged; article; chronic kidney failure; cohort analysis; controlled study; creatinine blood level; dialysis; disease association; disease course; female; follow up; glomerulus filtration rate; hazard ratio; high risk patient; hospital discharge; human; incidence; kidney surgery; long term care; major clinical study; male; mortality; multicenter study; outcome assessment; overall survival; priority journal; proportional hazards model; renal replacement therapy; risk assessment [SDGs]SDG3 |
Appears in Collections: | 醫學系 |
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