AKI Likely Has Long-Term Consequences

Adults who are hospitalized for acute kidney injury (AKI) likely have an elevated risk of poor long-term outcomes, according to a recent systematic review and meta-analysis.

Researchers arrived at this conclusion after evaluating 82 (N = 2,017,437) eligible studies of adults who had been hospitalized for AKI. Data were obtained through EMBASE and MEDLINE databases, as well as grey literature sources.

Specifically, the data indicated that patients with AKI had an increased risk of:

• New or progressive CKD (hazard ratio [HR] 2.67; 17.76 vs 7.59 cases per 100 person-years).
• End-stage kidney disease (HR 4.81; 0.47 vs 0.08 cases per 100 person-years).
• Death (HR 1.80; 13.19 vs 7.26 deaths per 100 person-years).

For all outcomes, a gradient of risk was evidence across increasing stages of AKI. However, the researchers noted that factors including clinical setting, baseline kidney function, diabetes, and coronary heart disease modified the magnitude of this risk.

“These findings establish the poor long-term outcomes of AKI while highlighting the importance of injury severity and clinical setting in the estimation of risk,” the researchers wrote.

—Christina Vogt

Reference:

See EJ, Jayasinghe K, Glassford N, et al. Long-term risk of adverse outcomes after acute kidney injury: a systematic review and meta-analysis of cohort studies using consensus definitions of exposure [Published online November 22, 2018]. Kidney Int. https://doi.org/10.1016/j.kint.2018.08.036.