BACKGROUND AND OBJECTIVES: Despite modern treatment, the case fatality rate of hospital-acquired acute kidney injury (HA-AKI) is still high. We retrospectively described the prevalence and the outcome of HA-AKI without nephrology referral (nrHA-AKI) and late referred HA-AKI patients to nephrologists (lrHA-AKI) compared with early referral patients (erHA-AKI) with respect to renal function recovery, renal replacement therapy (RRT) requirement, and in-hospital mortality of HA-AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Noncritically ill patients admitted to the tertiary care academic center of Lausanne, Switzerland, between 2004 and 2008 in the medical and surgical services were included. Acute kidney injury was defined using the Acute Kidney Injury Network (AKIN) classification. RESULTS: During 5 years, 4296 patients (4.12% of admissions) experienced 4727 episodes of HA-AKI during their hospital stay. The mean ± SD age of the patients was 61 ± 15 years with a 55% male predominance. There were 958 patients with nrHA-AKI (22.3%) and 2504 patients with lrHA-AKI (58.3%). RRT was required in 31% of the patients with lrHA-AKI compared with 24% of the patients with erHA-AKI. In the multiple risk factor analysis, compared with erHA-AKI, nrHA-AKI and lrHA-AKI were significantly associated with worse renal outcome and higher in-hospital mortality. CONCLUSIONS: These data suggest that HA-AKI is frequent and the patients with nrHA-AKI or lrHA-AKI are at increased risk for in-hospital morbidity and mortality.
BACKGROUND AND OBJECTIVES: Despite modern treatment, the case fatality rate of hospital-acquired acute kidney injury (HA-AKI) is still high. We retrospectively described the prevalence and the outcome of HA-AKI without nephrology referral (nrHA-AKI) and late referred HA-AKI patients to nephrologists (lrHA-AKI) compared with early referral patients (erHA-AKI) with respect to renal function recovery, renal replacement therapy (RRT) requirement, and in-hospital mortality of HA-AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Noncritically ill patients admitted to the tertiary care academic center of Lausanne, Switzerland, between 2004 and 2008 in the medical and surgical services were included. Acute kidney injury was defined using the Acute Kidney Injury Network (AKIN) classification. RESULTS: During 5 years, 4296 patients (4.12% of admissions) experienced 4727 episodes of HA-AKI during their hospital stay. The mean ± SD age of the patients was 61 ± 15 years with a 55% male predominance. There were 958 patients with nrHA-AKI (22.3%) and 2504 patients with lrHA-AKI (58.3%). RRT was required in 31% of the patients with lrHA-AKI compared with 24% of the patients with erHA-AKI. In the multiple risk factor analysis, compared with erHA-AKI, nrHA-AKI and lrHA-AKI were significantly associated with worse renal outcome and higher in-hospital mortality. CONCLUSIONS: These data suggest that HA-AKI is frequent and the patients with nrHA-AKI or lrHA-AKI are at increased risk for in-hospital morbidity and mortality.
Authors: Sehoon Park; Hyunjeong Cho; Seokwoo Park; Soojin Lee; Kwangsoo Kim; Hyung Jin Yoon; Jiwon Park; Yunhee Choi; Suehyun Lee; Ju Han Kim; Sejoong Kim; Ho Jun Chin; Dong Ki Kim; Kwon Wook Joo; Yon Su Kim; Hajeong Lee Journal: J Am Soc Nephrol Date: 2018-12-18 Impact factor: 10.121
Authors: Anitha Vijayan; Sarah Faubel; David J Askenazi; Jorge Cerda; William H Fissell; Michael Heung; Benjamin D Humphreys; Jay L Koyner; Kathleen D Liu; Girish Mour; Thomas D Nolin; Azra Bihorac Journal: Am J Kidney Dis Date: 2016-03-04 Impact factor: 8.860
Authors: Anja Haase-Fielitz; Saban Elitok; Martin Schostak; Martin Ernst; Berend Isermann; Christian Albert; Bernt-Peter Robra; Andreas Kribben; Michael Haase Journal: Dtsch Arztebl Int Date: 2020-04-24 Impact factor: 5.594
Authors: Ani Nalbandian; Kartik Sehgal; Aakriti Gupta; Mahesh V Madhavan; Claire McGroder; Jacob S Stevens; Joshua R Cook; Anna S Nordvig; Daniel Shalev; Tejasav S Sehrawat; Neha Ahluwalia; Behnood Bikdeli; Donald Dietz; Caroline Der-Nigoghossian; Nadia Liyanage-Don; Gregg F Rosner; Elana J Bernstein; Sumit Mohan; Akinpelumi A Beckley; David S Seres; Toni K Choueiri; Nir Uriel; John C Ausiello; Domenico Accili; Daniel E Freedberg; Matthew Baldwin; Allan Schwartz; Daniel Brodie; Christine Kim Garcia; Mitchell S V Elkind; Jean M Connors; John P Bilezikian; Donald W Landry; Elaine Y Wan Journal: Nat Med Date: 2021-03-22 Impact factor: 53.440