S TEO1, M BHATTI1, S KOTWAL1,2, S HERATH1, Z ENDRE1
1Prince Of Wales Hospital, Randwick, Australia, 2The George Institute, Sydney, Australia
Aim: To evaluate the outcomes at 1-year after acute kidney injury (AKI), including development of chronic kidney disease (CKD), cardiovascular events and factors associated with mortality.
Background: AKI is frequent in elderly patients. AKI carries the risk of mortality and progression to CKD. Risk factors for progression to CKD are not well-studied.
Methods: Data for all consecutive patients diagnosed with AKI by KDIGO criteria referred to the nephrology service from May to December 2017 were collected using hospital medical records. Patients on maintenance dialysis and <18 years old were excluded. Renal recovery was defined as return of estimated glomerular filtration rate (eGFR) to within 90% of baseline.
Results: Among the 99 patients (median age 74, IQR 58-84) with AKI, the mean baseline eGFR was 55 ± 25 ml/min. The majority were male (66%), 14 (14%) received renal replacement therapy during hospitalization and 14 (14%) died. Among the 85 survivors, 64 (75%) patients had not achieved renal recovery at discharge. At three months, only 53 patients were available for follow-up. Stage 3 and 4 CKD were present in 9 (17%), while 2 (4%) remained on dialysis. At 1 year after AKI, 42 patients were available for follow- up, with CKD Stage 3 in 10 (24%) patients and 2 (5%) patients remained on dialysis. Multivariate analysis showed that age was independently associated with 12-month mortality. At 1-year, the mortality was 25% while 7% had experienced an acute coronary event and 2% an acute arterial occlusion.
Conclusion: AKI is associated with high 1-year mortality, renal non-recovery and development of CKD. Age is independently associated with increased long-term mortality. The results support follow-up after AKI, especially in the elderly.
Dr Su Hooi Teo graduated with MD from the University of Calgary, Canada in 2005. She obtained her Membership from the Royal College of Physicians (MRCP) (United Kingdom) in 2011 and has subsequently completed her Advanced Specialty Training in Nephrology in Renal Medicine (Singapore) in 2014. She is currently undertaking a fellowship in Acute Kidney Injury (AKI) in Prince of Wales Hospital, Sydney. Her area of interests include General Nephrology, Critical Care Nephrology, Glomerular diseases and Hemodialysis.