GJ WILSON1,2, A MALLETT1,2,3,4, A KARK1,2, AK TAN2,5,A CAMERON1,2,4, Z WANG2,4, HG HEALY1,2, WE HOY2,4
1Department of Renal Medicine, Royal Brisbane and Women’s Hospital, Herston, Queensland; 2CKD.QLD & NHMRC CKD.CRE, University of Queensland, Herston, Queensland; 3Centre for Rare Diseases Research, Institute for Molecular Bioscience and School of Medicine, The University of Queensland, St Lucia, QLD; 4Centre for Chronic Disease, University of Queensland, Herston, Queensland; 5Department of Renal Medicine, Logan Hospital, Queensland
Aim: To describe the rates and characteristics of patients with AKI in an Australian CKD population.
Background: AKI is well described as a risk factor for the development and progression of CKD. However, AKI is a diverse clinical syndrome and what factors increase this risk has yet to be fully investigated.
Methods: Patients enrolled in the CKD.QLD registry from Logan Hospital and RBWH (n=2367) were assessed for a diagnosis of AKI either as the cause of CKD or as an acute on chronic kidney injury. The remaining patients were used as a comparator group (CKD only). Patient demographics, co-morbidities, cause of AKI and outcomes between and within these groups were compared.
Results: 159 patients (6.7%) had AKI as the cause of their CKD (primary AKI) and 176 (7.4%) had an acute on chronic kidney injury (AKI on CKD). There was a male predominance in patients with primary AKI compared to AKI on CKD and CKD only (61.4% vs. 55.1% & 50.3%; p=0.03). Patients with AKI on CKD were older than both primary AKI and CKD only patients (67.3 yrs vs. 62.3 & 64.7 yrs; p<0.01). Patients with primary AKI or with AKI on CKD had lower rates of diabetes mellitus and hypertension compared to CKD only (21.4% & 35.8% vs. 48.9% p<0.01; 52.8% & 73.9 vs. 77.8%; p<0.01). The most common causes of primary AKI and AKI on CKD were obstructive nephropathy (36.5% & 40.9%) and acute tubular necrosis (26.4% & 25.6%).
Conclusions: This is the first description of AKI in an Australian CKD population. Our findings confirm AKI as a significant risk factor for developing CKD even in the absence of other risk factors.