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Abstract: TH-OR116

AKI Is Associated with an Increased Risk of Dementia

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Kendrick, Jessica B., University of Colorado School of Medicine, Aurora, Colorado, United States
  • Holmen, John R., Intermountain Healthcare, Murray, Utah, United States
  • Srinivas, Titte, Intermountain Medical Center, Murray, Utah, United States
  • You, Zhiying, UC Denver, Aurora, Colorado, United States
  • Chonchol, Michel, University of Colorado, Aurora, Colorado, United States
  • Jovanovich, Anna Jeanette, Denver VA / University of Colorado, Denver, Colorado, United States
Background

Acute kidney injury (AKI) is associated with long-term adverse outcomes including development of chronic kidney disease, cardiovascular disease and mortality. Acute neurologic complications of acute kidney injury are well described but the long-term consequences of AKI on neurologic outcomes are unclear. We tested the hypothesis that AKI, even with complete kidney function recovery, is associated with a higher risk of developing dementia.

Methods

We performed a retrospective propensity score-matched analysis of 2,082 patients without prior history of dementia from an integrated health care delivery system in Utah, who had a hospital admission between January 1, 1999 and December 31, 2009. AKI was defined by ICD-9 codes and AKI Network serum creatinine values. 1041 patients with AKI followed by complete recovery, defined as discharge creatinine <1.10 times the pre-admission baseline value, were propensity score-matched with 1041 patients without AKI during the index admission. Dementia was defined by ICD-9 codes. Demographic, baseline serum creatinine, prior inpatient visits, season of admission, and all components of the Charlson Comorbidity index were used to generate the propensity score. Proportional hazards analysis was used to compare time to dementia among patients with and without AKI.

Results

After propensity score matching, covariates were well balanced between the groups. The mean (SD) age and baseline creatinine was 61 ± 16 years and 0.9 ± 0.2 mg/dL, respectively. During a median follow-up time of 5.8 years, 97 patients developed dementia. More patients with AKI developed dementia (7.0% vs. 2.3%). Patients with AKI had more than a 3-fold increased risk of developing dementia compared to those without AKI (Hazard Ratio 3.4, 95% CI 2.14 to 5.40).

Conclusion

AKI, even with complete kidney recovery, is associated with a significantly increased risk of hospitalized dementia. Further studies are needed to examine the association of AKI with cognitive dysfunction.

Funding

  • Other NIH Support