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Abstract: FR-PO031

AKI Followed by Complete Recovery Is Associated with Greater Risk of Subsequent Venous Thromboembolism

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Griffin, Benjamin, University of Colorado, Aurora, Colorado, United States
  • Shah, Neil Ramesh, University of Colorado, Aurora, Colorado, United States
  • You, Zhiying, UC Denver, Aurora, Colorado, United States
  • Holmen, John R., Intermountain Healthcare, Murray, Utah, United States
  • Srinivas, Titte, Intermountain Medical Center, Murray, Utah, United States
  • Chonchol, Michel, University of Colorado, Aurora, Colorado, United States
  • Faubel, Sarah, University of Colorado Denver , Denver, Colorado, United States
  • Jovanovich, Anna Jeanette, Denver VA , Denver, Colorado, United States
Background

Acute kidney injury (AKI) is associated with long-term morbidity including chronic kidney disease and heart disease. Recent data suggest that AKI is associated with increased long-term event rates such as sepsis, cancer, and venous thromboembolism (VTE). A prior study included patients with dialysis-requiring AKI with recovery but the degree of kidney function recovery was unclear. We aim to determine the risk of VTE following a hospital admission complicated by AKI with complete recovery in a propensity score-matched cohort of cases and controls.

Methods

We identified 1139 AKI cases (AKI Network definition) with complete kidney function recovery by the time of discharge, defined as serum creatinine <1.10 times the pre-admit baseline value, during a hospitalization between January 1, 1999 and December 31, 2009 from an integrated health care delivery system. We matched 1139 controls (no AKI during index admit) based on a propensity score including age, sex, race, number of prior inpatient visits, baseline creatinine, season of admission, and all co-morbidities in the Charlson Comorbidity index. The primary outcome was time to VTE. Cox proportional hazards models were adjusted for history of prior VTE and cancer and censored for death.

Results

Baseline characteristics among the cases and controls were similar: age 62 ± 17 years, 46% female, 92% white, serum creatinine 0.9 ± 0.2 mg/dL. During a median [IQR] post-discharge follow-up of 65 [9-89] months, 246 cases (22%) and 73 controls (6%) developed new VTE. In the unadjusted Cox model AKI with complete recovery was with a nearly four-fold increase in hazard ratio for subsequent VTE (HR 3.99 [95% CI, 3.06 – 5.18]; p <0.0001). This association did not change after adjusting for prior VTE and cancer diagnosis (HR 3.82 [95% CI, 2.94 – 4.97]; p <0.0001).

Conclusion

AKI with complete recovery is associated with increased risk of VTE. These data further support the idea that AKI is associated with long-term events dysfunction independent of decreased kidney function. Future research is needed to determine the mechanism of long-term changes following AKI.

Funding

  • Veterans Affairs Support