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10.2215/CJN.01240214

http://scihub22266oqcxt.onion/10.2215/CJN.01240214
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C4348674!4348674!25527706
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suck abstract from ncbi


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pmid25527706      Clin+J+Am+Soc+Nephrol 2015 ; 10 (3): 353-62
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  • Long-Term Risk of Upper Gastrointestinal Hemorrhage after Advanced AKI #MMPMID25527706
  • Wu PC; Wu CJ; Lin CJ; Wu VC
  • Clin J Am Soc Nephrol 2015[Mar]; 10 (3): 353-62 PMID25527706show ga
  • Background and objectives: There are few reports on temporary dialysis-requiring AKI as a risk factor for future upper gastrointestinal bleeding (UGIB). This study sought to explore the long-term association between dialysis-requiring AKI and UGIB. Design, setting, participants, & measurements: This nationwide cohort study used data from the Taiwan National Health Insurance Research Database. Patients who recovered from dialysis-requiring AKI and matched controls were selected from hospitalized patients age ?18 years between 1998 and 2006. The cumulative incidences of long-term de novo UGIB were calculated, and the risk factors of UGIB and mortality were identified using time-varying Cox proportional hazard models adjusted for subsequent CKD and ESRD after AKI. Results: A total of 4565 AKI-recovery patients and the same number of matched patients without AKI were analyzed. After a median follow-up time of 2.33 years (interquartile range, 0.97?4.81 years), the incidence rates of UGIB were 50 (by stringent criterion) and 69 (by lenient criterion) per 1000 patient-years in the AKI-recovery group and 31 (by stringent criterion) and 48 (by lenient criterion) per 1000 patient-years in the non-AKI group (both P<0.001). When compared with patients in the non-AKI group, the multivariate hazard ratio (HR) for UGIB was 1.30 (95% confidence interval [95% CI], 1.14 to 1.48) for dialysis-requiring AKI, 1.83 (95% CI, 1.53 to 2.20) for time-varying CKD, and 2.31 (95% CI, 1.92 to 2.79) for time-varying ESRD (all P<0.001). Finally, the risk for long-term mortality increased after UGIB (HR, 1.24; 95% CI, 1.12 to 1.38) and dialysis-requiring AKI (HR, 1.66; 95% CI, 1.54 to 1.78). Conclusions: Recovery from dialysis-requiring AKI was associated with future UGIB and mortality.
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