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Hospital-acquired acute kidney injury: an analysis of baseline estimated glomerular filtration rate and in-hospital mortality

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Abstract

Aim

The objective of this study was to determine whether the baseline estimated glomerular filtration rate (eGFR) level was independently associated with in-hospital mortality in generalized patients with hospital-acquired acute kidney injury (HA-AKI) in China.

Methods

All of the patients admitted to a tertiary medical center of Nanjing, China, between January 1, 2013, and December 31, 2013, were involved. Through the use of an electronic database and the Acute Kidney Injury Network (AKIN) classification, the patients with HA-AKI were indentified. We included the hospitalized adult patients with HA-AKI. Epidemiological information and in-hospital outcomes were collected and were analyzed according to different baseline eGFR strata of the included individual patients.

Results

Of the 42,664 admissions during the study period, 1327 patients were identified as AKI. The incidence of HA-AKI was 3.1 %. HA-AKI patients with a compromised baseline eGFR tended to be older and had a higher prevalence of various comorbid conditions. With the gradual deterioration of the baseline eGFR, the odds ratio of in-hospital mortality increased incrementally and a graded independent association between the baseline eGFR and in-hospital mortality was observed when the baseline eGFR dropped below 60 ml/min per 1.73 m2.

Conclusion

Baseline eGFR was a potential risk factor for in-hospital mortality in HA-AKI. Serum Creatinine (SCr)-based definition of AKI needs to incorporate baseline eGFR to optimize or refine risk stratification.

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Acknowledgements

The study was funded by Jiangsu Provincial Special Program of Medical Science (BL2014080) and the National Nature Science Foundation of China (81370919, 81130010).

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    Authors and Affiliations

    1. Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, 210009, China

      Yu-Chen Han, Yan Tu, Hong Liu, Ming-Ming Pan, Ri-Ning Tang & Bi-Cheng Liu

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    1. Yu-Chen Han
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    2. Yan Tu
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    3. Hong Liu
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    Correspondence to Bi-Cheng Liu.

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    The authors declare that they have no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    For this retrospective study formal consent is not required.

    Additional information

    Y.-C. Han and Y. Tu contributed equally to this work.

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    Han, YC., Tu, Y., Liu, H. et al. Hospital-acquired acute kidney injury: an analysis of baseline estimated glomerular filtration rate and in-hospital mortality. J Nephrol 29, 411–418 (2016). https://doi.org/10.1007/s40620-015-0238-5

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    • DOI: https://doi.org/10.1007/s40620-015-0238-5

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