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Mild Stage 1 post-operative acute kidney injury : association with chronic kidney disease and long-term survival

Long, Thorir Einarsson LU ; Helgason, Dadi LU ; Helgadottir, Solveig ; Sigurdsson, Gisli Heimir ; Palsson, Runolfur ; Sigurdsson, Martin Ingi and Indridason, Olafur Skuli (2021) In Clinical Kidney Journal 14(1). p.237-244
Abstract

BACKGROUND: Mild cases of acute kidney injury (AKI) are identified by a small rise in serum creatinine (SCr) according to the KDIGO AKI definition. The aim of this study was to examine the long-term outcomes of individuals with mild AKI.Methods. This was a retrospective cohort study of all adult patients who underwent abdominal, cardiothoracic, vascular or orthopaedic surgery at Landspitali-The National University Hospital of Iceland in 1998-2015. Incident chronic kidney disease (CKD), progression of pre-existing CKD and long-term survival were compared between patients with mild Stage 1 AKI (defined as a rise in SCr of ≥26.5 μmol/L within 48 h post-operatively without reaching 1.5× baseline SCr within 7 days), and a propensity... (More)

BACKGROUND: Mild cases of acute kidney injury (AKI) are identified by a small rise in serum creatinine (SCr) according to the KDIGO AKI definition. The aim of this study was to examine the long-term outcomes of individuals with mild AKI.Methods. This was a retrospective cohort study of all adult patients who underwent abdominal, cardiothoracic, vascular or orthopaedic surgery at Landspitali-The National University Hospital of Iceland in 1998-2015. Incident chronic kidney disease (CKD), progression of pre-existing CKD and long-term survival were compared between patients with mild Stage 1 AKI (defined as a rise in SCr of ≥26.5 μmol/L within 48 h post-operatively without reaching 1.5× baseline SCr within 7 days), and a propensity score-matched control group without AKI stratified by the presence of CKD.

RESULTS: Pre- and post-operative SCr values were available for 47 333 (42%) surgeries. Of those, 1161 (2.4%) had mild Stage 1 AKI and 2355 (5%) more severe forms of AKI. Mild Stage 1 AKI was associated with both incident CKD and progression of pre-existing CKD (P < 0.001). After exclusion of post-operative deaths within 30 days, mild Stage 1 AKI was not associated with worse 1-year survival in patients with preserved kidney function (94% versus 94%, P = 0.660), and same was true for patients with pre-operative CKD (83% versus 82%, P = 0.870) compared with their matched individuals. Conclusions. Mild Stage 1 AKI is associated with development and progression of CKD, but not with inferior 1-year survival. These findings support the inclusion of a small absolute increase in SCr in the definition of AKI.

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author
; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
in
Clinical Kidney Journal
volume
14
issue
1
pages
8 pages
publisher
Oxford University Press
external identifiers
  • scopus:85099155355
  • pmid:33564424
ISSN
2048-8505
DOI
10.1093/ckj/sfz197
language
English
LU publication?
no
additional info
© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA.
id
a08f43e6-3dae-41d7-a9c4-6828511a8524
date added to LUP
2024-12-05 16:10:20
date last changed
2025-06-20 19:28:31
@article{a08f43e6-3dae-41d7-a9c4-6828511a8524,
  abstract     = {{<p>BACKGROUND: Mild cases of acute kidney injury (AKI) are identified by a small rise in serum creatinine (SCr) according to the KDIGO AKI definition. The aim of this study was to examine the long-term outcomes of individuals with mild AKI.Methods. This was a retrospective cohort study of all adult patients who underwent abdominal, cardiothoracic, vascular or orthopaedic surgery at Landspitali-The National University Hospital of Iceland in 1998-2015. Incident chronic kidney disease (CKD), progression of pre-existing CKD and long-term survival were compared between patients with mild Stage 1 AKI (defined as a rise in SCr of ≥26.5 μmol/L within 48 h post-operatively without reaching 1.5× baseline SCr within 7 days), and a propensity score-matched control group without AKI stratified by the presence of CKD.</p><p>RESULTS: Pre- and post-operative SCr values were available for 47 333 (42%) surgeries. Of those, 1161 (2.4%) had mild Stage 1 AKI and 2355 (5%) more severe forms of AKI. Mild Stage 1 AKI was associated with both incident CKD and progression of pre-existing CKD (P &lt; 0.001). After exclusion of post-operative deaths within 30 days, mild Stage 1 AKI was not associated with worse 1-year survival in patients with preserved kidney function (94% versus 94%, P = 0.660), and same was true for patients with pre-operative CKD (83% versus 82%, P = 0.870) compared with their matched individuals. Conclusions. Mild Stage 1 AKI is associated with development and progression of CKD, but not with inferior 1-year survival. These findings support the inclusion of a small absolute increase in SCr in the definition of AKI.</p>}},
  author       = {{Long, Thorir Einarsson and Helgason, Dadi and Helgadottir, Solveig and Sigurdsson, Gisli Heimir and Palsson, Runolfur and Sigurdsson, Martin Ingi and Indridason, Olafur Skuli}},
  issn         = {{2048-8505}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{237--244}},
  publisher    = {{Oxford University Press}},
  series       = {{Clinical Kidney Journal}},
  title        = {{Mild Stage 1 post-operative acute kidney injury : association with chronic kidney disease and long-term survival}},
  url          = {{http://dx.doi.org/10.1093/ckj/sfz197}},
  doi          = {{10.1093/ckj/sfz197}},
  volume       = {{14}},
  year         = {{2021}},
}