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Kidney Week

Abstract: FR-PO029

Recovery and Survival at Three Months Following Dialysis-Dependent AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Bertoni, Isabela V., Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, United Kingdom
  • Zhu, Doreen, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, United Kingdom
  • Turner, Michael P., University of Oxford, Oxford, United Kingdom
  • Haynes, Richard, University of Oxford, Oxford, United Kingdom
Background

Recovery from dialysis-dependent AKI is desirable because long-term dialysis is associated with significant morbidity and mortality. We examined how previous CKD stage, aetiology of AKI and co-morbidities influenced survival and dialysis dependence at three months after initial presentation.

Methods

245 consecutive cases of AKI requiring RRT were identified from a tertiary referral centre in the UK, treated between 2008 and 2018. Baseline demographic and comorbidity data were extracted and logistic regression was used to assess the association of these characteristics with the primary outcome of renal recovery and survival at three months, in uni- and multi-variate models.

Results

Median age was 66 years (IQR 56.5-75). The most common diagnosis was ATN (60%) followed by vasculitis (9%) and myeloma (8%). At three months after presentation, 187 (76%) individuals were dialysis independent and 30 (12%) had died. Unadjusted and adjusted odds ratios (OR) are shown in table one. (Odds >1 means factor was associated with worse outcome).

Conclusion

This single centre study demonstrated that prior CKD stage and a history of cancer and higher were of the strongest predictors of renal recovery and survival at three months. This could assist clinical decision making and information given to patients.

Table 1: Unadjusted and adjusted odds ratios (OR) for association of patient characteristics with dialysis dependence and/or mortality at three months post presentation
VariableUnadjusted OR95% CIp-valueAdjusted OR95% CIp-value
Age (decades)1.251.03-1.530.0241.110.80-1.550.447
Male sex (ref female)1.100.61-1.980.7571.030.41-2.630.944
Diagnosis (ref ATN)
Myeloma2.620.98-6.990.0543.800.68-21.40.130
Vasculitis3.281.29-8.310.0123.560.77-16.50.104
Obstruction2.620.87-7.940.0881.230.26-5.850.799
Other1.310.54-3.210.5532.170.62-7.480.220
Previous CKD
Stage 21.130.22-5.860.8871.130.19-6.910.887
Stage 33.101.18-8.120.0212.680.83-8.670.100
Stage 44.131.35-12.60.0134.561.22-17.10.024
Stage 52.760.71-10.70.1424.250.95-19.10.059
Co-morbidities
History of cancer2.141.11-4.140.0233.111.19-8.080.020
Prior vascular disease *1.761.00-3.090.0491.760.66-4.690.261
Prior diabetes mellitus0.800.44-1.450.4591.020.38-2.740.971
Dementia2.580.36-18.70.3481.650.12-23.50.710

*not included in final model