NDLI: Non-recovery from dialysis-requiring acute kidney injury and short-term mortality and cardiovascular risk: a cohort study

Content Provider	Springer Nature : BioMed Central
Author	Lee, Benjamin J. Hsu, Chi-yuan Parikh, Rishi V. Leong, Thomas K. Tan, Thida C. Walia, Sophia Liu, Kathleen D. Hsu, Raymond K. Go, Alan S.
Abstract	Background The high mortality and cardiovascular disease (CVD) burden in patients with end-stage renal disease (ESRD) is well-documented. Recent literature suggests that acute kidney injury is also associated with CVD. It is unknown whether patients with incident ESRD due to dialysis-requiring acute kidney injury (AKI-D) are at higher short-term risk for death and CVD events, compared with incident ESRD patients without preceding AKI-D. Few studies have examined the impact of recovery from AKI-D on subsequent CVD risk. Methods In this retrospective cohort study, we evaluated adult members of Kaiser Permanente Northern California who initiated dialysis from January 2009 to September 2015. Preceding AKI-D and subsequent outcomes of death and CVD events (acute coronary syndrome, heart failure, ischemic stroke or transient ischemic attack) were identified from electronic health records. We performed multivariable Cox regression models adjusting for demographics, comorbidities, medication use, and laboratory results. Results Compared to incident ESRD patients who experienced AKI-D (n = 1865), patients with ESRD not due to AKI-D (n = 3772) had significantly lower adjusted rates of death (adjusted hazard ratio [aHR] 0.56, 95% CI: 0.47–0.67) and heart failure hospitalization (aHR 0.45, 0.30–0.70). Compared to AKI-D patients who did not recover and progressed to ESRD, AKI-D patients who recovered (n = 1347) had a 30% lower adjusted relative rate of death (aHR 0.70, 0.55–0.88). Conclusions Patients who transition to ESRD via AKI-D are a high-risk subgroup that may benefit from aggressive monitoring and medical management, particularly for heart failure. Recovery from AKI-D is independently associated with lower short-term mortality.
Related Links	https://bmcnephrol.biomedcentral.com/counter/pdf/10.1186/s12882-018-0924-3.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	14712369
DOI	10.1186/s12882-018-0924-3
Journal	BMC Nephrology
Issue Number	1
Volume Number	19
Language	English
Publisher	BioMed Central
Publisher Date	2018-06-11
Access Restriction	Open
Subject Keyword	Nephrology Internal Medicine Cardiovascular events Mortality End-stage renal disease Dialysis-requiring acute kidney injury Renal recovery
Content Type	Text
Resource Type	Article
Subject	Nephrology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

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