Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Improved long-term survival and renal recovery after acute kidney injury in hospitalized patients : A 20 year experience

Long, Thorir E LU ; Sigurdsson, Martin I ; Sigurdsson, Gisli H and Indridason, Olafur S (2016) In Nephrology 21(12). p.1027-1033
Abstract

AIM: Acute kidney injury (AKI) is a common complication of medical and surgical interventions in hospitalized patients and associates with high mortality. Our aim was to examine renal recovery and long-term survival and time trends in AKI survival.

METHODS: Changes in serum creatinine (SCr) were used to define AKI in patients at Landspitali University Hospital in Iceland from 1993 to 2013. Renal recovery was defined as SCr < 1.5× baseline.

RESULTS: Out of 25 274 individuals who had their highest measured SCr during hospitalization and an available baseline SCr, 10,419 (41%) had AKI during hospitalization (H-AKI), 19%, 11% and 12% with Stage 1, 2 and 3, respectively. The incidence of H-AKI increased from 18.6 (95% CI,... (More)

AIM: Acute kidney injury (AKI) is a common complication of medical and surgical interventions in hospitalized patients and associates with high mortality. Our aim was to examine renal recovery and long-term survival and time trends in AKI survival.

METHODS: Changes in serum creatinine (SCr) were used to define AKI in patients at Landspitali University Hospital in Iceland from 1993 to 2013. Renal recovery was defined as SCr < 1.5× baseline.

RESULTS: Out of 25 274 individuals who had their highest measured SCr during hospitalization and an available baseline SCr, 10,419 (41%) had AKI during hospitalization (H-AKI), 19%, 11% and 12% with Stage 1, 2 and 3, respectively. The incidence of H-AKI increased from 18.6 (95% CI, 14.7-22.5) to 29.9 (95% CI, 26.7-33.1) per 1000 admissions/year over the study period. Survival after H-AKI was 61% at 90-days and 51% at one year. Comparing H-AKI patients to propensity score matched individuals the hazard ratio for death was 1.49 (1.36-1.62), 2.17 (1.95-2.41) and 2.95 (2.65-3.29) for Stage 1, 2 and 3, respectively. One-year survival of H-AKI patients improved from 47% in 1993-1997 to 57% in 2008-2013 and the adjusted hazard ratio for mortality improved, compared to the first 5-year period, 0.85 (0.81-0.89), 0.67 (0.64-0.71), and 0.57 (0.53-0.60) for each subsequent 5-year interval. Recovery of renal function was achieved in 88%, 58% and 44% of patients in Stages 1, 2 and 3, respectively, improving with time.

CONCLUSIONS: Acute kidney injury is an independent predictor of long-term mortality in hospitalized patients but there has been a marked improvement in survival and renal recovery over the past two decades.

(Less)
Please use this url to cite or link to this publication:
author
; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Acute Kidney Injury/blood, Adult, Aged, Aged, 80 and over, Biomarkers/blood, Chi-Square Distribution, Creatinine/blood, Female, Humans, Iceland/epidemiology, Incidence, Inpatients, Kaplan-Meier Estimate, Kidney/physiopathology, Kidney Function Tests, Male, Middle Aged, Propensity Score, Proportional Hazards Models, Recovery of Function, Risk Factors, Time Factors, Treatment Outcome
in
Nephrology
volume
21
issue
12
pages
1027 - 1033
publisher
Wiley-Blackwell
external identifiers
  • scopus:84994904904
  • pmid:26660951
ISSN
1320-5358
DOI
10.1111/nep.12698
language
English
LU publication?
no
additional info
© 2015 Asian Pacific Society of Nephrology.
id
52c9a733-bf62-4f28-a731-29f2199b953a
date added to LUP
2024-12-05 16:14:15
date last changed
2025-01-17 07:34:12
@article{52c9a733-bf62-4f28-a731-29f2199b953a,
  abstract     = {{<p>AIM: Acute kidney injury (AKI) is a common complication of medical and surgical interventions in hospitalized patients and associates with high mortality. Our aim was to examine renal recovery and long-term survival and time trends in AKI survival.</p><p>METHODS: Changes in serum creatinine (SCr) were used to define AKI in patients at Landspitali University Hospital in Iceland from 1993 to 2013. Renal recovery was defined as SCr &lt; 1.5× baseline.</p><p>RESULTS: Out of 25 274 individuals who had their highest measured SCr during hospitalization and an available baseline SCr, 10,419 (41%) had AKI during hospitalization (H-AKI), 19%, 11% and 12% with Stage 1, 2 and 3, respectively. The incidence of H-AKI increased from 18.6 (95% CI, 14.7-22.5) to 29.9 (95% CI, 26.7-33.1) per 1000 admissions/year over the study period. Survival after H-AKI was 61% at 90-days and 51% at one year. Comparing H-AKI patients to propensity score matched individuals the hazard ratio for death was 1.49 (1.36-1.62), 2.17 (1.95-2.41) and 2.95 (2.65-3.29) for Stage 1, 2 and 3, respectively. One-year survival of H-AKI patients improved from 47% in 1993-1997 to 57% in 2008-2013 and the adjusted hazard ratio for mortality improved, compared to the first 5-year period, 0.85 (0.81-0.89), 0.67 (0.64-0.71), and 0.57 (0.53-0.60) for each subsequent 5-year interval. Recovery of renal function was achieved in 88%, 58% and 44% of patients in Stages 1, 2 and 3, respectively, improving with time.</p><p>CONCLUSIONS: Acute kidney injury is an independent predictor of long-term mortality in hospitalized patients but there has been a marked improvement in survival and renal recovery over the past two decades.</p>}},
  author       = {{Long, Thorir E and Sigurdsson, Martin I and Sigurdsson, Gisli H and Indridason, Olafur S}},
  issn         = {{1320-5358}},
  keywords     = {{Acute Kidney Injury/blood; Adult; Aged; Aged, 80 and over; Biomarkers/blood; Chi-Square Distribution; Creatinine/blood; Female; Humans; Iceland/epidemiology; Incidence; Inpatients; Kaplan-Meier Estimate; Kidney/physiopathology; Kidney Function Tests; Male; Middle Aged; Propensity Score; Proportional Hazards Models; Recovery of Function; Risk Factors; Time Factors; Treatment Outcome}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{1027--1033}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Nephrology}},
  title        = {{Improved long-term survival and renal recovery after acute kidney injury in hospitalized patients : A 20 year experience}},
  url          = {{http://dx.doi.org/10.1111/nep.12698}},
  doi          = {{10.1111/nep.12698}},
  volume       = {{21}},
  year         = {{2016}},
}