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Kidney Week

Abstract: TH-PO027

Characteristics of Patients Readmitted to Hospital One Year Following an Episode of AKI

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Lewington, Andrew J.P., Leeds Teaching Hospitals, Leeds, United Kingdom
  • Goorachan, Steven, St. James Hospital, Leeds, United Kingdom
  • Ahmad, Fazeel, Leeds teaching Hospitals, Leeds, United Kingdom
  • Miller, Adrian G., Leeds teaching Hospitals NHS Trust, Leeds, United Kingdom
Background

Acute kidney injury (AKI) is a risk factor for further episodes of AKI. We have analysed the characteristics of a cohort of patients who had an AKI identified by an AKI e-alert and who were readmitted within a 1 year

Methods

Data was gathered on patients admitted to a teaching hospital who had an AKI e-alert (2015 - 2017) and who were subsequently readmitted within 1 year. The electronic health care records (EHR) of these patients were reviewed

Results

2010 patients were identified of which 1513 patients had an initial length of stay〈 30 days. Initial review of 302 patient EHR from this subgroup (n=1513) excluded 52 patients who did not have a clinical episode of AKI. The remaining cohort (n=251) had a mean age of 73 yrs (25-99 yrs ) with 135 (54%) males and 116 (46%) females. The mean length of stay was 16 days and the cause of AKI was poorly documented in the EHR. The reason for admission was multifactorial (30%) sepsis (26%), cardiac failure (15%), hypovolaemia (8%), malignancy (8%) obstruction (5%), trauma (5%) and abdominal surgery (3%). The 1 yr mortality was 37% and this increased with age; 20.9% (〈 60 yrs), 33.3% (〈 60-79 yrs) and 42.2% (〉80yrs). At 3 months recovery of kidney function to the original eGFR occurred in 20.3% of patients. 10.7% of patients experienced a reduction in kidney function to〈 50% of their baseline eGFR. Recovery of eGFR to baseline at 3 months did not result in improvement in 1 year mortality rate 32.8% versus 29.2% in those patients whose kidney function did not return to baseline eGFR. The mean time to readmission was 68.4 days (range 1-336 days). The cause for readmission was the same in only 20% of patients. Only 23.9% of those readmitted had a further episode of AKI either at the time of readmission or throughout the subsequent length of hospital stay.

Conclusion

Acute kidney injury has been identified as a risk factor for recurrent episodes of AKI. In our ongoing analysis of a large cohort of patients only 23.9% of those readmitted had an episode of AKI at the time of readmission or throughout the subsequent length of hospital stay. The reason for readmission was the same for only 20% of the patients. Nearly 80% of patients fail to fully recover kidney function by 3 months. Further analysis of the characteristics of this cohort are ongoing and will be presented.