Sasa Nie1, Zhe Feng1, Li Tang1, Xiaolong Wang1, Yani He2, Jingai Fang3, Suhua Li4, Yibin Yang5, Huijuan Mao6, Jundong Jiao7, Wenhu Liu8, Ning Cao9, Wenge Wang10, Jifeng Sun11, Fengmin Shao12, Wenge Li13, Qiang He14, Hongli Jiang15, Hongli Lin16, Ping Fu17, Xinzhou Zhang18, Yinghong Liu19, Yonggui Wu20, ChunSheng Xi21, Meng Liang22, Zhijie Qu23, Jun Zhu24, Guangli Wu25, Yali Zheng26, Yu Na27, Ying Li28, Wei Li29, Guangyan Cai1, Xiangmei Chen1. 1. Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, China. 2. Department of Nephrology, Daping Hospital, the Third Military Medical University, Chongqing, China. 3. Department of Nephrology, the First Hospital of Shanxi Medical University, Taiyuan, China. 4. Department of Nephrology, the First Affiliate Hospital of Xinjiang Medical University, Urumqi, China. 5. Department of Nephrology, Affiliated Hospital of Zunyi Medical University, Zunyi, China. 6. Department of Nephrology, the Jiangsu Province Hospital, Nanjing, China. 7. Department of Nephrology, the Second Affiliated Hospital of Harbin Medical University, Harbin, China. 8. Department of Nephrology, Beiijng Freindship Hospital, Capital Medical University, Beijing, China. 9. Department of blood purification, General Hospital of Shenyang Military Area Command, Shenyang, China. 10. Department of Nephrology, Lanzhou University Second hospital, Lanzhou, China. 11. Department of Nephrology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China. 12. Department of Nephrology, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China. 13. Department of Nephrology, China-Japan Friendship Hospital, Beijing, China. 14. Department of Nephrology, Zhejiang Provincial People's Hospital, Hangzhou, China. 15. Blood purification center, the First Affiliated Hospital of Xian Jiaotong University, Xi'an, China. 16. Department of Nephrology, the First Affiliated Hospital of Dalian Medical University, Dalian, China. 17. Department of Nephrology, West China Hospital of Sichuan University, Chengdu, China. 18. Department of Nephrology, Shenzhen People's Hospital, Shenzhen, China. 19. Department of Nephrology, the Second Xiangya Hospital, Central South University, Changsha, China. 20. Department of Nephrology, the Frist Affiliated Hospital of Anhui Medical university, Hefei, China. 21. Department of Nephrology, the Lanzhou Military General Hospital, Lanzhou, China. 22. Department of Nephrology, Chenggong Hospital Xiamen University, Xiamen, China. 23. Department of Nephrology, the Second Hospital of Jilin University, Changchun, China. 24. Department of Nephrology, the Chengdu Military General Hospital, Chengdu, China. 25. Department of Nephrology, the Bethune international peace hospital of PLA, Shijiazhuang, China. 26. Department of Nephrology, Ningxia People's Hospital, Yinchuan, China. 27. Department of Nephrology, the 306th Hospital of PLA, Beijing, China. 28. Department of Nephrology, the Third Hospital of Hebei Medical University, Shijiazhuang, China. 29. Department of Nephrology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
Abstract
BACKGROUND/AIMS: Risk factor studies for acute kidney injury (AKI) in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. METHODS: All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes' definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality. RESULTS: The morbidity of AKI was 0.97%. Independent risk factors for AKI were advancing age, male gender, hypertension, and chronic kidney disease. All-cause mortality was 16.5%. The predictors of mortality in AKI patients were advancing age, tumor, higher uric acid level and increases in Acute Physiologic Assessment and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. The hazard ratio (HR) for mortality with uric acid levels > 9.1 mg/dl compared with ≤ 5.2 mg/dl was 1.78 (95% CI: 1.23 to 2.58) for the AKI patients as a group, and was 1.73 (95% CI: 1.24 to 2.42) for a propensity score-matched set. CONCLUSION: In addition to traditional risk factors, uric acid level is an independent predictor of all-cause mortality after AKI.
BACKGROUND/AIMS: Risk factor studies for acute kidney injury (AKI) in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. METHODS: All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes' definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality. RESULTS: The morbidity of AKI was 0.97%. Independent risk factors for AKI were advancing age, male gender, hypertension, and chronic kidney disease. All-cause mortality was 16.5%. The predictors of mortality in AKI patients were advancing age, tumor, higher uric acid level and increases in Acute Physiologic Assessment and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. The hazard ratio (HR) for mortality with uric acid levels > 9.1 mg/dl compared with ≤ 5.2 mg/dl was 1.78 (95% CI: 1.23 to 2.58) for the AKI patients as a group, and was 1.73 (95% CI: 1.24 to 2.42) for a propensity score-matched set. CONCLUSION: In addition to traditional risk factors, uric acid level is an independent predictor of all-cause mortality after AKI.
Authors: Kathleen D Liu; Stuart L Goldstein; Anitha Vijayan; Chirag R Parikh; Kianoush Kashani; Mark D Okusa; Anupam Agarwal; Jorge Cerdá Journal: Clin J Am Soc Nephrol Date: 2020-04-21 Impact factor: 8.237