Kidney Week

Abstract: SA-PO546

Nephrology Consultation After AKI Can Improve Patients’ In-Hospital Survival

Session Information

• AKI: Clinical, Outcomes, Trials - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Lee, Jeonghwan, SMG-SNU Boramae Medical Center, Seoul, Korea (the Republic of)

Jeonghwan Lee,

• Ryu, Ji Young, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)

Ji Young Ryu,

• Son, Hyung Eun, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)

Hyung Eun Son,

• Chin, Ho Jun, Seoul National University Bundang Hospital, Seong nam, Korea (the Republic of)

Ho Jun Chin,

• Na, Ki Young, Seoul National University Bundang Hospital, Seong nam, Korea (the Republic of)

Ki Young Na,

• Kim, Sejoong, Seoul National University Bundang Hospital, Seong nam, Korea (the Republic of)

Sejoong Kim,

Background

The significance of nephrology consultation in patients with acute kidney injury (AKI) is not well established.

Methods

We enrolled a total of 20,914 patients who were admitted to the Seoul National University Bundang Hospital from January 1, 2013 to December 31, 2013. All clinical and laboratory data were retrieved retrospectively from the electronic medical record database.

Results

In total, 2,603 (12.4%) patients had AKI during admission (8.7% AKI stage 1, 2.1% AKI stage 2, 1.6% AKI stage 3). Among the 2603 patients with AKI, 446 (17.1%) patients were referred to nephrologists for consultation. Patients who were referred to nephrologists showed characteristics of older age (68.7 ± 14.6 vs. 66.3 ± 15.7 years old, P = 0.0002), male preponderance (60.8% vs. 55.6 %, P = 0.045), more surgical operation (39.7% vs. 29.6%, P < 0.001), more ICU care (51.8% vs 24.1%, P < 0.001), increased baseline creatinine level (1.51 ± 1.58 vs. 1.05 ± 1.28, P < 0.001), high comorbidity score (0.89 ± 1.00 vs. 0.67 ± 0.75), and more advanced AKI stage (eg. AKI stage 3, 33.6% vs. 9.0%, P < 0.001). Overall, patients who were referred to nephrologists for consultation showed similar survival rate compared with patients who were not consulted to nephrologist (log-rank P = 0.223, HR 1.190 (0.899-1.575). After propensity score matching (1:1, n= 359 in both group), both group showed comparable clinical characteristics, and nephrology consulted patients showed better survival outcomes (log-rank P = 0.07, HR 0.614 (0.428-0.881). The time from AKI to nephrology consultation and time to answer after consultation did not significantly affect patient survival.

Conclusion

Patients with AKI who were consulted to nephrologists have a better survival prognosis than those who were not. AKI patients should be encouraged to be consulted to nephrologists for appropriate management and improvement of clinical outcomes.

Propensity Score Matched Patients Survival after AKI according to the Nephrology Consultation.