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Abstract: FR-PO030

AKI Followed by Complete Recovery Is Associated with Higher Risk of Upper Gastrointestinal Bleed

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Shafiq, Asad, University of Colorado, Aurora, Colorado, United States
  • You, Zhiying, UC Denver, Aurora, Colorado, United States
  • Griffin, Benjamin, University of Colorado, 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

Recovery from dialysis dependent AKI is associated with future risk of upper gastrointestinal bleed (UGIB). To date, no studies have explored the association between complete recovery from non-dialysis dependent AKI and future risk of UGIB. We aim to determine the long-term risk of UGIB after a hospital admission complicated by non-dialysis dependent AKI followed by complete recovery of kidney function in a propensity score-matched cohort of cases and controls.

Methods

We identified 1140 AKI cases (AKI Network definition) with complete kidney function recovery at the time of discharge (serum creatinine <1.10 times the pre-admit baseline value) during hospital admission between January 1, 1999 and December 31, 2009 from an integrated health care delivery system. We matched 1140 controls (no AKI during index admit) based on a propensity score including: age, sex, race, prior inpatient visits, all components of the Charlson Comorbidity index, baseline creatinine, and admission season. The primary outcome was time to UGIB, defined by ICD-9 codes. Cox proportional hazards models were adjusted for prior UGIB, liver disease, and peptic ulcer disease (PUD) and censored for death.

Results

Baseline characteristics among the cases and controls were similar: age 62±17 years, 46% female, 92% white, baseline creatinine 0.9 ± 0.2 mg/dL. During a median post-discharge follow-up of 13 months, 646 (57%) cases and 470 (41%) controls had an UGIB. The risk of UGIB was 1.6 times higher among patients with AKI followed by complete recovery compared to controls (Hazard Ratio 1.65 [95% CI, 1.46 – 1.86]; p <0.0001). After adjusting the model for prior UGIB, liver disease, and PUD, the risk of UGIB was still higher among the patients with AKI followed by complete recovery compared to control group (Hazard Ratio 1.50 [95% CI, 1.32 – 1.69]; p <0.0001).

Conclusion

In this cohort, non-dialysis dependent AKI during a hospital admission, despite complete recovery of kidney function, was associated with future UGIB compared to patients without AKI. Future studies are needed to further investigate this relationship.

Funding

  • Veterans Affairs Support