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Recurrent acute kidney injury in elderly patients is common and associated with 1-year mortality

  • Nephrology - Original Paper
  • Published:
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Abstract

Background

Acute kidney injury (AKI) is common among elderly patients after a first hospitalized AKI. Patients who recover are at risk for recurrence, but recurrent geriatric AKI is not well-studied.

Methods

This was a retrospective, 12-month cohort study using data from the National Clinical Research Center for Geriatric Diseases. Recurrent AKI was defined as a new spontaneous rise of ≥ 0.3 mg/dl (≥ 26.5 µmol/L) within 48 h or a 50% increase in serum creatinine (Scr) from the baseline within 7 days after the previous AKI episode. The outcome measured was 12-month mortality.

Results

Among 1711 study patients, 652 developed AKI. Of the 429 AKI survivors in whom recovery could be assessed, 314 patients recovered to their baseline renal function, and 115 patients developed chronic kidney disease (CKD). Of the group that recovered renal function, 90 patients (28.7%) subsequently developed recurrent AKI, while 224 (71.3%) did not. Of the 429 survivors with AKI, 103 patients (24.0%) died within 12 months. Multivariate logistic regression analysis revealed that recurrent AKI was significantly associated with coronary disease (odds ratio [OR = 2.008; 95% confidence interval [CI] 1.024–3.938; P = 0.042), a need for mechanical ventilation (OR = 2.265; 95% CI 1.267–4.051; P = 0.006) and high blood urea nitrogen levels (OR = 1.036; 95% CI 1.002–1.072; P = 0.040) at the first AKI event. Kaplan–Meier curves showed the 12-month survival of patients with non-recurrent AKI was better than that of patients with CKD, and survival of patients with recurrent AKI was worse than that of patients with CKD (log rank P < 0.001). In the multivariate Cox regression analysis, mortality at 12 month was higher in the patient with recurrent AKI as compared with those with a single episode (HR = 3.375; 95% CI 2.241–5.083; P < 0.001).

Conclusion

Recurrent AKI is common among elderly patients who recovered their renal function post-AKI and is associated with significantly higher 12-month mortality compared with CKD patients.

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Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This manuscript was edited for English language by American Journal Experts (AJE).

Funding

This study was funded by grants from the Special Scientific Research Project of Military Health Care (grant No. 20BJZ27 to Dr. FHZ), the Military Medical Innovation Project (grant No. 18CXZ026 and CX19010 to Dr FHZ).

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Authors and Affiliations

  1. Department of Critical Care Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China

    Qinglin Li, Zhi Mao, Hongjun Kang & Feihu Zhou

  2. Chinese PLA General Hospital National Clinical Research Center for Geriatric Diseases, Beijing, 100853, China

    Feihu Zhou

Authors
  1. Qinglin Li
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  2. Zhi Mao
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  3. Hongjun Kang
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  4. Feihu Zhou
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Corresponding author

Correspondence to Feihu Zhou.

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The authors declare that they have no competing interests.

Ethical approval

This study has been approved by the Ethics Committee of the Chinese PLA General Hospital (number: S2017–054–01).

Informed consent

The requirement to obtain written informed consent from each patient was waived because this was an observational retrospective study.

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Li, Q., Mao, Z., Kang, H. et al. Recurrent acute kidney injury in elderly patients is common and associated with 1-year mortality. Int Urol Nephrol 54, 2911–2918 (2022). https://doi.org/10.1007/s11255-022-03181-w

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  • DOI: https://doi.org/10.1007/s11255-022-03181-w

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