Abstract: SA-PO877
Higher Discharge Serum Creatinine Is Associated with CKD Among Survivors of AKI
Session Information
- CKD: Pharmacoepidemiology
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Wu, Binbin, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
- Yang, Yi, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
- Chen, Jianghua, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
Background
Despite many studies showing patients have higher risk of developing chronic kidney disease (CKD) after a hospitalization with acute kidney injury (AKI), data on the prognostic value of discharge serum creatinine (SCr) are limited. The aim of this study is to explore the association between discharge SCr and CKD risk among survivors of AKI.
Methods
From January 2011 through December 2011, patients hospitalized with AKI in the First Affiliated Hospital, College of Medicine, Zhejiang University without known CKD were screened. The primary endpoint was CKD progression within 5 years. The association between discharge SCr and CKD was assessed by multivariate logistic regression. The net reclassification improvement(NRI) and integrated discrimination improvement (IDI) statistics were applied in statistical analysis.
Results
673 patients was enrolled and 526 (78.1%) progressed to CKD in 5 years' follow-up. After adjusting for age, gender, stage of AKI, diabetes, hypertension, coronary heart disease, proteinuria and baseline SCr, the odds ratio(OR) rose with the increase of discharge SCr. Multivariable model showed prognostic significance, with the area under the receiver operating characteristic curve (AUC) of 0.77. The addition of discharge SCr to established risk factors improved risk prediction of CKD (AUC of 0.841; NRI of 18.18%; IDI of 10.12%, all P < 0.01).
Conclusion
Higher levels of discharge SCr were associated with increased risk of CKD among survivors of AKI, indicating that discharge SCr could be a predictor independent of established conventional risk factors.
Table 1. Discharge SCr concentrations prediction of CKD with AUC.
| AUC | ||||||
| Endpoint | Discharge SCr | Risk factors | Risk factors with discharge SCr | Incremental area (P) | NRI (P) | IDI (P) |
| CKD | 0.763 | 0.77 | 0.841 | 0.071 (P < 0.01) | 0.182 (P < 0.01) | 0.101 (P < 0.01) |
Established risk factors including age, gender, stage of AKI, diabetes, coronary artery disease, hypertension, proteinuria and baseline SCr.
ORs were adjusted for age, gender, stage of AKI, diabetes, hypertension, coronary artery disease, proteinuria and baseline serum creatinine.