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  4. Acute-on-chronic kidney injury at hospital discharge is associated with long-term dialysis and mortality
 
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Acute-on-chronic kidney injury at hospital discharge is associated with long-term dialysis and mortality

Journal
Kidney International
Journal Volume
80
Journal Issue
11
Pages
1222-1230
Date Issued
2011
Author(s)
VIN-CENT WU  
TAO-MIN HUANG  
CHUN-FU LAI  
Chih-Chung Shiao
YU-FENG LIN  
TZONG-SHINN CHU  
Pei-Chen Wu
CHIA-TER CHAO  
JANN-YUAN WANG  
Tze-Wah Kao
Guang-Huar Young
Pi-Ru Tsai
HUNG-BIN TSAI  
Chieh-Li Wang
Ming-Shou Wu
WEN-CHIH CHIANG  
I-JUNG TSAI  
Fu-Chang Hu
SHUEI-LIONG LIN  
YUNG-MING CHEN  
TUN-JUN TSAI  
Wen-Je Ko
KWAN-DUN WU  
DOI
10.1038/ki.2011.259
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
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.
SDGs

[SDGs]SDG3

Other Subjects
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
Publisher
Nature Publishing Group
Type
journal article

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