Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26356
Title: Epidemiology and Outcomes of Acute Kidney Diseases: A Comparative Analysis.
Austin Authors: See, Emily J ;Polkinghorne, Kevan R;Toussaint, Nigel D;Bailey, Michael;Johnson, David W;Bellomo, Rinaldo 
Affiliation: School of Medicine, Monash University, Melbourne, Victoria, Australia
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
Translational Research Institute, Brisbane, Queensland, Australia
Australasian Kidney Trials Network, Brisbane, Queensland, Australia
Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia
Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
Data Analytics Research and Evaluation (DARE) Centre
Intensive Care
Department of Nephrology, Monash Health, Clayton, Victoria, Australia
Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Centre for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australia
School of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Department of Epidemiology and Preventative Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
Issue Date: 27-Apr-2021
metadata.dc.date: 2021-04-27
Publication information: American Journal of Nephrology 2021; online first: 27 April
Abstract: Acute kidney diseases and disorders (AKD) encompass acute kidney injury (AKI) and subacute or persistent alterations in kidney function that occur after an initiating event. Unlike AKI, accurate estimates of the incidence and prognosis of AKD are not available and its clinical significance is uncertain. We studied the epidemiology and long-term outcome of AKD (as defined by the KDIGO criteria), with or without AKI, in a retrospective cohort of adults hospitalized at a single centre for >24 h between 2012 and 2016 who had a baseline eGFR ≥60 mL/min/1.73 m2 and were alive at 30 days. In patients for whom follow-up data were available, the risks of major adverse kidney events (MAKEs), CKD, kidney failure, and death were examined by Cox and competing risk regression analyses. Among 62,977 patients, 906 (1%) had AKD with AKI and 485 (1%) had AKD without AKI. Follow-up data were available for 36,118 patients. In this cohort, compared to no kidney disease, AKD with AKI was associated with a higher risk of MAKEs (40.25 per 100 person-years; hazard ratio [HR] 2.51, 95% confidence interval [CI] 2.16-2.91), CKD (27.84 per 100 person-years); subhazard ratio [SHR] 3.18, 95% CI 2.60-3.89), kidney failure (0.56 per 100 person-years; SHR 24.84, 95% CI 5.93-104.03), and death (14.86 per 100 person-years; HR 1.52, 95% CI 1.20-1.92). Patients who had AKD without AKI also had a higher risk of MAKEs (36.21 per 100 person-years; HR 2.26, 95% CI 1.89-2.70), CKD (22.94 per 100 person-years; SHR 2.69, 95% CI 2.11-3.43), kidney failure (0.28 per 100 person-years; SHR 12.63, 95% CI 1.48-107.64), and death (14.86 per 100 person-years; HR 1.57, 95% CI 1.19-2.07). MAKEs after AKD were driven by CKD, especially in the first 3 months. These findings establish the burden and poor prognosis of AKD and support prioritisation of clinical initiatives and research strategies to mitigate such risk.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26356
DOI: 10.1159/000515231
PubMed URL: 33906191
Type: Journal Article
Subjects: Acute kidney disease
Chronic kidney disease
Death
Kidney failure
Major adverse kidney events
Appears in Collections:Journal articles

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