AKI - human studies

Abstract

Introduction and Aims: The aim of the study was to assess characteristics, renal survival and mortality of patients who developed acute kidney injury (AKI) stage 3, according to KDIGO guidelines, and needed renal replacement therapy (RRT), not in intensive care unit. Methods: All patients who required RRT due to AKI stage 3 along one year were included, excluding patients in intensive care unit. Demographic and personal history data, previous renal function, cause of AKI, renal function, renal survival, and mortality at one and three months after AKI were recorded. Results: A total of 60 patients were enrolled (incidence 150 patients/106 population/ year). Mean age 73.6±13.6 (range 25-91), 53.3% men. Patient's characteristics: 80% were hypertensive, 32% were diabetics, 42% were dyslipemics, 43% were obese, 23% were smokers, and 58% with chronic renal failure (28.1% stage 3, 21.1% stage 4, and 8.8% stage 5). Cause of AKI: renal disease 60%, prerenal 32% and obstructive causes 8%. Renal function: serum creatinine before AKI 1.78±1.2 mg/dL; maximum serum creatinine during AKI hospitalization 7.48±4.04 mg/dL; at discharge, 3±2.1 mg/dL; one month later, 1.94±1.02 mg/dL; and three months later, 2.51±1.76 mg/dL. 21.7% die during hospitalization, 15% kept on RRT at discharge, and 63.3 recovered partially or complete renal function. One month after AKI, 25% had die, 15 kept on RRT, and 58.3% recovered partially or complete renal function, 1.7% was missing. Three months after AKI, 30% died, 15% kept on RRT, and 48.3% recovered partially or complete renal function, 6.7% was missing. Previous renal function according to KDOQI classification of patients who survived three months after AKI, was: stage 1 7.9%, 2 34.2%, 3 23.7%, 4 15.8% and 5 10.5%; at discharge, renal function was: stage 1 2.6%, 2 2.6%, 3 15.8%, 4 39.5% and 5 28.2%; one month after AKI was: stage 2 10.5%, 3 28.9%, 4 21.1%, and 5 22.9%. Conclusions: In our health area AKI stage 3 requiring RRT have a incidence similar to other studies. Mortality in AKI patients increase in time, reaching 30% three months after AKI episode, while renal survival keeps stable in this period. Patients who underwent an AKI requiring RRT showed glomerular filtration rate decreasing three months later.