Short- and long-term outcomes after non-severe acute kidney injury
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Severe acute kidney injury (AKI) is associated with chronic kidney disease (CKD), cardiovascular events and increased mortality. However, little is known about the prognosis in hospitalized population suffering from non-severe AKI episodes. The aim of this study is to determine the impact of non-severe AKI episodes in cardiovascular events, mortality and CKD, on short and long term.
Retrospective cohort study to 360 patients who met the criteria for diagnosis of AKI according ADQI guidelines with full recovery of renal function after the AKI episode, admitted between January 2000 and December 2010 in our hospital. Follow-up was 4 years after the diagnosis of AKI. Covariates included demographic variables, baseline creatinine and diagnosis of comorbidities.
360 AKI survivor patients were included. Twenty five of them (6.7%) had developed CKD after 1-year follow-up. Hypertension (OR 1.62; 95% CI 1.2–2.6, p < 0.05) and serum creatinine >2.6 mg/dL in AKI (OR 1.7; 95% CI 1.2–3.7, p < 0.05) were independent risk factors. After 4-year follow-up, 40 patients (18.3%) had developed CKD; age >66 years was an independent risk factor (OR 1.03, 95% CI 1.03–1.06, p < 0.05). Mortality rate at 4 years was 25.3% and was significantly higher in CKD patients (OR 4.3, 95% CI 1.13–4.90, p < 0.05) and patients >66 years (OR 1.12, 95% CI 1.02–1.06, p < 0.05). The incidence of cardiovascular events also was higher in CKD patients than in non-CKD patients (62.7 vs. 21.7%, p < 0.05).
Even after fully recovered non-severe AKI episodes, some patients develop CKD and those have an increase in the incidence of cardiovascular events and long-term mortality.
KeywordsNon-severe acute kidney injury Chronic kidney disease Cardiovascular events Mortality
This work was made by Carlos Arias as part of his thesis project in the Department of Medicine, Universitat Autonoma of Barcelona.
Compliance with ethical standards
Julio Pascual is supported by FIS ISCIII-FEDER PI13/00598, PI16/00617, and RedinRen RD16/0009/0013. María José Soler is supported by FIS ISCIII-FEDER PI14/00557.
No external funding.
Conflict of interest
The authors declare that there is no conflict of interests regarding publication of this paper.
This study is adhered to the Principles of Helsinki Declaration and was approved by the hospital’s Ethics Committee (CEIC-IMAS) with IRB number 201/3777/I. Written informed consent was not required because of the non-intervention and retrospective chart review design.
Human and animal rights statement
This article does not contain any studies with animals performed by any of the authors.
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