Long-term outcomes of community-acquired versus hospital-acquired acute kidney injury: a retrospective analysis

Long-term outcomes of community-acquired versus hospital-acquired acute kidney injury: a retrospective analysis. Der Mesropian, P. J., Kalamaras, J. S., Eisele, G., Phelps, K. R., Asif, A., & Mathew, R. O. Clinical Nephrology, 81(3):174–184, March, 2014.
doi abstract bibtex

AIM: To compare long-term outcomes in CA-AKI to HA-AKI. The hypothesis was that renal and patient survival would be better in CA-AKI than in HA-AKI. METHODS: Retrospective cohort analysis of patients hospitalized from 2004 to 2005, in Upstate New York Veterans Affairs hospitals. The groups: CA-AKI (n = 560), HA-AKI (n = 158), or No AKI (NA) (n = 2,320). Risk, injury, failure, loss, and end-stage kidney (RIFLE) criterion was used to define AKI. PRIMARY OUTCOMES: doubling of serum creatinine, endstage renal disease (ESRD), death, and a composite of the three. SECONDARY OUTCOMES: de novo chronic kidney disease (CKD), recovery of renal function, and re-admission rate. The cumulative incidence of outcomes was determined over a period of 3 years after discharge. RESULTS: CA-AKI was 3.5 times as prevalent as HA-AKI. In comparison to patients with HA-AKI, those with CA-AKI had better estimated glomerular filtration rate (71.3 vs. 61.1 mL/min/1.73 m(2), p \textless 0.001) and lower prevalence of CKD (42.3 vs. 51.9%, p = 0.03) at baseline. More patients with CA-AKI than HA-AKI met RIFLE failure criterion (43.8 vs. 29.1%, p \textless 0.001). By 3 years, no differences were found for the individual primary and secondary outcomes tested (all p \textgreater 0.05). CONCLUSIONS: CA-AKI was found to be considerably more common than HA-AKI and had similar long-term consequences.

@article{der_mesropian_long-term_2014,
	title = {Long-term outcomes of community-acquired versus hospital-acquired acute kidney injury: a retrospective analysis},
	volume = {81},
	issn = {0301-0430},
	shorttitle = {Long-term outcomes of community-acquired versus hospital-acquired acute kidney injury},
	doi = {10.5414/CN108153},
	abstract = {AIM: To compare long-term outcomes in CA-AKI to HA-AKI. The hypothesis was that renal and patient survival would be better in CA-AKI than in HA-AKI.
METHODS: Retrospective cohort analysis of patients hospitalized from 2004 to 2005, in Upstate New York Veterans Affairs hospitals. The groups: CA-AKI (n = 560), HA-AKI (n = 158), or No AKI (NA) (n = 2,320). Risk, injury, failure, loss, and end-stage kidney (RIFLE) criterion was used to define AKI.
PRIMARY OUTCOMES: doubling of serum creatinine, endstage renal disease (ESRD), death, and a composite of the three.
SECONDARY OUTCOMES: de novo chronic kidney disease (CKD), recovery of renal function, and re-admission rate. The cumulative incidence of outcomes was determined over a period of 3 years after discharge.
RESULTS: CA-AKI was 3.5 times as prevalent as HA-AKI. In comparison to patients with HA-AKI, those with CA-AKI had better estimated glomerular filtration rate (71.3 vs. 61.1 mL/min/1.73 m(2), p {\textless} 0.001) and lower prevalence of CKD (42.3 vs. 51.9\%, p = 0.03) at baseline. More patients with CA-AKI than HA-AKI met RIFLE failure criterion (43.8 vs. 29.1\%, p {\textless} 0.001). By 3 years, no differences were found for the individual primary and secondary outcomes tested (all p {\textgreater} 0.05).
CONCLUSIONS: CA-AKI was found to be considerably more common than HA-AKI and had similar long-term consequences.},
	language = {eng},
	number = {3},
	journal = {Clinical Nephrology},
	author = {Der Mesropian, Paul J. and Kalamaras, John S. and Eisele, George and Phelps, Kenneth R. and Asif, Arif and Mathew, Roy O.},
	month = mar,
	year = {2014},
	pmid = {24361059},
	keywords = {Acute Kidney Injury, Biomarkers, Chi-Square Distribution, Creatinine, Disease Progression, Glomerular Filtration Rate, Hospitalization, Hospitals, Veterans, Humans, Incidence, Kaplan-Meier Estimate, Kidney, Kidney Failure, Chronic, Logistic Models, Multivariate Analysis, New York, Prevalence, Proportional Hazards Models, Recovery of Function, Retrospective Studies, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome},
	pages = {174--184}
}

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PRIMARY OUTCOMES: doubling of serum creatinine, endstage renal disease (ESRD), death, and a composite of the three. SECONDARY OUTCOMES: de novo chronic kidney disease (CKD), recovery of renal function, and re-admission rate. The cumulative incidence of outcomes was determined over a period of 3 years after discharge. RESULTS: CA-AKI was 3.5 times as prevalent as HA-AKI. In comparison to patients with HA-AKI, those with CA-AKI had better estimated glomerular filtration rate (71.3 vs. 61.1 mL/min/1.73 m(2), p \\textless 0.001) and lower prevalence of CKD (42.3 vs. 51.9%, p = 0.03) at baseline. More patients with CA-AKI than HA-AKI met RIFLE failure criterion (43.8 vs. 29.1%, p \\textless 0.001). By 3 years, no differences were found for the individual primary and secondary outcomes tested (all p \\textgreater 0.05). 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The hypothesis was that renal and patient survival would be better in CA-AKI than in HA-AKI.\nMETHODS: Retrospective cohort analysis of patients hospitalized from 2004 to 2005, in Upstate New York Veterans Affairs hospitals. The groups: CA-AKI (n = 560), HA-AKI (n = 158), or No AKI (NA) (n = 2,320). Risk, injury, failure, loss, and end-stage kidney (RIFLE) criterion was used to define AKI.\nPRIMARY OUTCOMES: doubling of serum creatinine, endstage renal disease (ESRD), death, and a composite of the three.\nSECONDARY OUTCOMES: de novo chronic kidney disease (CKD), recovery of renal function, and re-admission rate. The cumulative incidence of outcomes was determined over a period of 3 years after discharge.\nRESULTS: CA-AKI was 3.5 times as prevalent as HA-AKI. In comparison to patients with HA-AKI, those with CA-AKI had better estimated glomerular filtration rate (71.3 vs. 61.1 mL/min/1.73 m(2), p {\\textless} 0.001) and lower prevalence of CKD (42.3 vs. 51.9\\%, p = 0.03) at baseline. 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