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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Am+Soc+Nephrol
2016 ; 27
(4
): 1190-200
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Predictors of Recurrent AKI
#MMPMID26264853
Siew ED
; Parr SK
; Abdel-Kader K
; Eden SK
; Peterson JF
; Bansal N
; Hung AM
; Fly J
; Speroff T
; Ikizler TA
; Matheny ME
J Am Soc Nephrol
2016[Apr]; 27
(4
): 1190-200
PMID26264853
show ga
Recurrent AKI is common among patients after hospitalized AKI and is associated
with progressive CKD. In this study, we identified clinical risk factors for
recurrent AKI present during index AKI hospitalizations that occurred between
2003 and 2010 using a regional Veterans Administration database in the United
States. AKI was defined as a 0.3 mg/dl or 50% increase from a baseline creatinine
measure. The primary outcome was hospitalization with recurrent AKI within 12
months of discharge from the index hospitalization. Time to recurrent AKI was
examined using Cox regression analysis, and sensitivity analyses were performed
using a competing risk approach. Among 11,683 qualifying AKI hospitalizations,
2954 patients (25%) were hospitalized with recurrent AKI within 12 months of
discharge. Median time to recurrent AKI within 12 months was 64 (interquartile
range 19-167) days. In addition to known demographic and comorbid risk factors
for AKI, patients with longer AKI duration and those whose discharge diagnosis at
index AKI hospitalization included congestive heart failure (primary diagnosis),
decompensated advanced liver disease, cancer with or without chemotherapy, acute
coronary syndrome, or volume depletion, were at highest risk for being
hospitalized with recurrent AKI. Risk factors identified were similar when a
competing risk model for death was applied. In conclusion, several inpatient
conditions associated with AKI may increase the risk for recurrent AKI. These
findings should facilitate risk stratification, guide appropriate patient
referral after AKI, and help generate potential risk reduction strategies.
Efforts to identify modifiable factors to prevent recurrent AKI in these patients
are warranted.