Small Acute Increases in Serum Creatinine Are Associated with Decreased Long-Term Survival in the Critically Ill
(2014) In American Journal of Respiratory and Critical Care Medicine 189(9). p.1075-1081- Abstract
- Rationale: Long-term outcomes after acute kidney injury (AKI) are poorly described. Objectives: We hypothesized that one single episode of minimal (stage 1) AKI is associated with reduced long-term survival compared with no AKI after recovery from critical illness. Methods: A prospective cohort of 2,010 intensive care unit (ICU) patients admitted to the ICU between years 2000 and 2009 at a provincial tertiary care hospital. Development of AKI was determined according to the KDIGO classification and mortality up to 10 years after ICU admission was recorded. Measurements and Main Results: Of the 1,844 eligible patients, 18.4% had AKI stage 1, 12.1% had stage 2, 26.5% had stage 3, and 43.0% had no AKI. The 28-day, 1-year, 5-year, and 10-year... (More)
- Rationale: Long-term outcomes after acute kidney injury (AKI) are poorly described. Objectives: We hypothesized that one single episode of minimal (stage 1) AKI is associated with reduced long-term survival compared with no AKI after recovery from critical illness. Methods: A prospective cohort of 2,010 intensive care unit (ICU) patients admitted to the ICU between years 2000 and 2009 at a provincial tertiary care hospital. Development of AKI was determined according to the KDIGO classification and mortality up to 10 years after ICU admission was recorded. Measurements and Main Results: Of the 1,844 eligible patients, 18.4% had AKI stage 1, 12.1% had stage 2, 26.5% had stage 3, and 43.0% had no AKI. The 28-day, 1-year, 5-year, and 10-year survival rates were 67.1%, 51.8%, 44.1%, and 36.3% in patients with mild AKI, which was significantly worse compared with the critically ill patients with no AKI at any time (P < 0.01). The unadjusted 10-year mortality hazard ratio was 1.53 (95% confidence interval, 1.2-2.0) for 28-day survivors with stage 1 AKE compared with critically ill patients with no AKI. Adjusted 10-year mortality risk was 1.26 (1.0-1.6). After propensity matching stage 1 AKI with no AKE patients, mild AKE was still significantly associated with decreased 10-year survival (P =0.036). Conclusions: Patients with one episode of mild AKI have significantly lower long-term survival rates than critically ill patients with no AKI. Close medical follow-up of these patients may be warranted and mechanistic research is required to understand how AKI influences long-term events. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4482352
- author
- Linder, Adam LU ; Fjell, Chris ; Levin, Adeera ; Walley, Keith R. ; Russell, James A. and Boyd, John H.
- organization
- publishing date
- 2014
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- acute kidney injury, long-term survival, critical illness
- in
- American Journal of Respiratory and Critical Care Medicine
- volume
- 189
- issue
- 9
- pages
- 1075 - 1081
- publisher
- American Thoracic Society
- external identifiers
-
- wos:000335366500012
- scopus:84899832419
- pmid:24601781
- ISSN
- 1535-4970
- DOI
- 10.1164/rccm.201311-2097OC
- language
- English
- LU publication?
- yes
- id
- d2802b1a-b6d0-48fc-b50b-50e82f78f882 (old id 4482352)
- date added to LUP
- 2016-04-01 10:02:48
- date last changed
- 2022-04-04 01:44:32
@article{d2802b1a-b6d0-48fc-b50b-50e82f78f882,
abstract = {{Rationale: Long-term outcomes after acute kidney injury (AKI) are poorly described. Objectives: We hypothesized that one single episode of minimal (stage 1) AKI is associated with reduced long-term survival compared with no AKI after recovery from critical illness. Methods: A prospective cohort of 2,010 intensive care unit (ICU) patients admitted to the ICU between years 2000 and 2009 at a provincial tertiary care hospital. Development of AKI was determined according to the KDIGO classification and mortality up to 10 years after ICU admission was recorded. Measurements and Main Results: Of the 1,844 eligible patients, 18.4% had AKI stage 1, 12.1% had stage 2, 26.5% had stage 3, and 43.0% had no AKI. The 28-day, 1-year, 5-year, and 10-year survival rates were 67.1%, 51.8%, 44.1%, and 36.3% in patients with mild AKI, which was significantly worse compared with the critically ill patients with no AKI at any time (P < 0.01). The unadjusted 10-year mortality hazard ratio was 1.53 (95% confidence interval, 1.2-2.0) for 28-day survivors with stage 1 AKE compared with critically ill patients with no AKI. Adjusted 10-year mortality risk was 1.26 (1.0-1.6). After propensity matching stage 1 AKI with no AKE patients, mild AKE was still significantly associated with decreased 10-year survival (P =0.036). Conclusions: Patients with one episode of mild AKI have significantly lower long-term survival rates than critically ill patients with no AKI. Close medical follow-up of these patients may be warranted and mechanistic research is required to understand how AKI influences long-term events.}},
author = {{Linder, Adam and Fjell, Chris and Levin, Adeera and Walley, Keith R. and Russell, James A. and Boyd, John H.}},
issn = {{1535-4970}},
keywords = {{acute kidney injury; long-term survival; critical illness}},
language = {{eng}},
number = {{9}},
pages = {{1075--1081}},
publisher = {{American Thoracic Society}},
series = {{American Journal of Respiratory and Critical Care Medicine}},
title = {{Small Acute Increases in Serum Creatinine Are Associated with Decreased Long-Term Survival in the Critically Ill}},
url = {{http://dx.doi.org/10.1164/rccm.201311-2097OC}},
doi = {{10.1164/rccm.201311-2097OC}},
volume = {{189}},
year = {{2014}},
}