Background: The baseline creatinine level is central in the Kidney Disease Improving Global Outcomes (KDIGO) criteria of AKI, but baseline creatinine is often inconsistently defined or unavailable in AKI research. We examined the rate, characteristics, and 30-day mortality of AKI in five AKI cohorts created using different definitions of baseline creatinine. Methods: This nationwide cohort study included all individuals aged ≥18 years in Denmark with a creatinine measurement in 2017. Applying the KDIGO criteria, we created four AKI cohorts using four different baseline definitions (most recent, mean, or median value of outpatient creatinine 365-368 days before, or median value 90-98 days before, if available, otherwise median value 365-391 days before) and one AKI cohort not using a baseline value. AKI rate and the distribution of age, sex, baseline creatinine, and comorbidity were described for each AKI cohort, and the 30-day all-cause mortality was estimated using the Kaplan-Meier method. Results: The study included 2,095,850 adults with at least one creatinine measurement in 2017. The four different baseline definitions identified between 61,189 and 62,597 AKI episodes. The AKI rate in these four cohorts was 13-14 per 1000 person-years, and 30-day all-cause mortality was 17%-18%. The cohort created without using a baseline creatinine included 37,659 AKI episodes, corresponding to an AKI rate of 8.2 per 1000 person-years and a 30-day mortality of 23%. All five cohorts were similar regarding age, sex, and comorbidity. Conclusions: In a population-based setting with available outpatient baseline creatinine, different baseline creatinine definitions revealed comparable AKI cohorts, whereas the lack of a baseline creatinine when defining AKI led to a smaller AKI cohort with a higher mortality. These findings underscore the importance of availability and consistent use of an outpatient baseline creatinine, particulary in studies of community-acquired AKI.
Background: The baseline creatinine level is central in the Kidney Disease Improving Global Outcomes (KDIGO) criteria of AKI, but baseline creatinine is often inconsistently defined or unavailable in AKI research. We examined the rate, characteristics, and 30-day mortality of AKI in five AKI cohorts created using different definitions of baseline creatinine. Methods: This nationwide cohort study included all individuals aged ≥18 years in Denmark with a creatinine measurement in 2017. Applying the KDIGO criteria, we created four AKI cohorts using four different baseline definitions (most recent, mean, or median value of outpatient creatinine 365-368 days before, or median value 90-98 days before, if available, otherwise median value 365-391 days before) and one AKI cohort not using a baseline value. AKI rate and the distribution of age, sex, baseline creatinine, and comorbidity were described for each AKI cohort, and the 30-day all-cause mortality was estimated using the Kaplan-Meier method. Results: The study included 2,095,850 adults with at least one creatinine measurement in 2017. The four different baseline definitions identified between 61,189 and 62,597 AKI episodes. The AKI rate in these four cohorts was 13-14 per 1000 person-years, and 30-day all-cause mortality was 17%-18%. The cohort created without using a baseline creatinine included 37,659 AKI episodes, corresponding to an AKI rate of 8.2 per 1000 person-years and a 30-day mortality of 23%. All five cohorts were similar regarding age, sex, and comorbidity. Conclusions: In a population-based setting with available outpatient baseline creatinine, different baseline creatinine definitions revealed comparable AKI cohorts, whereas the lack of a baseline creatinine when defining AKI led to a smaller AKI cohort with a higher mortality. These findings underscore the importance of availability and consistent use of an outpatient baseline creatinine, particulary in studies of community-acquired AKI.
Authors: Edward D Siew; T Alp Ikizler; Michael E Matheny; Yaping Shi; Jonathan S Schildcrout; Ioana Danciu; Jamie P Dwyer; Manakan Srichai; Adriana M Hung; James P Smith; Josh F Peterson Journal: Clin J Am Soc Nephrol Date: 2012-03-15 Impact factor: 8.237
Authors: Kianoush Kashani; Min Shao; Guangxi Li; Amy W Williams; Andrew D Rule; Walter K Kremers; Michael Malinchoc; Ognjen Gajic; John C Lieske Journal: Kidney Int Date: 2017-05-18 Impact factor: 10.612
Authors: Charuhas V Thakar; Annette Christianson; Ron Freyberg; Peter Almenoff; Marta L Render Journal: Crit Care Med Date: 2009-09 Impact factor: 7.598
Authors: Françoise Pontet; Ulla Magdal Petersen; Xavier Fuentes-Arderiu; Gunnar Nordin; Ivan Bruunshuus; Jarkko Ihalainen; Daniel Karlsson; Urban Forsum; René Dybkaer; Gunther Schadow; Wolf Kuelpmann; Georges Férard; Dongchon Kang; Clement McDonald; Gilbert Hill Journal: Stud Health Technol Inform Date: 2009
Authors: Elizabeth Crellin; Kathryn E Mansfield; Clémence Leyrat; Dorothea Nitsch; Ian J Douglas; Adrian Root; Elizabeth Williamson; Liam Smeeth; Laurie A Tomlinson Journal: BMJ Date: 2018-02-09
Authors: Johan Frederik Håkonsen Arendt; Anette Tarp Hansen; Søren Andreas Ladefoged; Henrik Toft Sørensen; Lars Pedersen; Kasper Adelborg Journal: Clin Epidemiol Date: 2020-05-18 Impact factor: 4.790