Hospitalization for AKI correlates with risk of death, rehospitalization

Key points to remember:

• AKI during hospitalization is correlated with an increased risk of mortality.
• This correlation occurs in patients with and without chronic kidney disease.

According to data from American Journal of Kidney Disease.

“We hope this study will lead to a growing awareness of the dramatic increase in adverse risks following hospitalization with AKI – outcomes that could significantly affect health,” Ivonne H Schulman, MD, program director at the National Institute of Diabetes and Digestive and Kidney Diseases, said in a news release. “There is currently no standard of care for people hospitalized with AKI, and this information could help us get there.”

In a retrospective study, the researchers’ propensity score matched data from 471,176 patients hospitalized with AKI to patients hospitalized without AKI between January 2007 and September 2020. Data is from Optum Clinformatics.

The researchers used the cumulative incidence function method to determine the incidences of rehospitalization and death, then compared the results with Gray’s test. Using Cox models, the researchers measured the relationship between AKI and the primary outcomes of all-cause rehospitalization, selected-cause rehospitalization, and mortality at 90 and 365 days after index hospitalization. . Additionally, researchers conducted pooled and stratified analyzes to assess interactions between AKI hospitalizations and pre-existing chronic kidney disease.

Ninety days after hospitalization, analyzes revealed an association between AKI and increased rates of rehospitalization due to any cause, end-stage renal disease, heart failure, sepsis, pneumonia, myocardial infarction and volume depletion. These results remained constant at 365 days. According to the preliminary release, patients with ARI were 62% more likely to undergo rehospitalization and 266% more likely to die of any cause within 90 days of discharge.

The researchers identified a higher mortality rate in the group with AKI than in those without at day 90 and day 365. Overall, the risk of outcomes increased when the researchers stratified the patients by CKD status.

“Evidence from randomized trials is needed to determine whether preventive strategies or interventions given early in AKI can reduce the risk of future renal and cardiovascular adverse events. The results of the present study demonstrate that preventive strategies and interventions are needed in patients with and without pre-existing CRF,” Schulman and colleagues wrote. They added: “Although the best clinical management regimen for ARI after hospitalization remains to be determined, these results highlight the immediate need for close monitoring after hospitalization of people with ARI.

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