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Abstract: TH-PO095

Differences on Outcomes Between AKI and AKI on CKD in Community-Acquired AKI

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Claure-Del Granado, Rolando, Hospital Obrero #2 - C.N.S.; Universidad Mayor de San Simon, School of Medicine, Cochabamba, Cercado, Bolivia, Plurinational State of
  • Ramirez-Yapura, Susana G., Hospital Obrero #2 - C.N.S., Cochabamba, Bolivia, Plurinational State of
  • Burdmann, Emmanuel A., University of Sao Paulo Medical School, Sao Paulo, Brazil
  • Yu, Luis, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
  • Younes-Ibrahim, Mauricio, University of Rio de Janeiro, Rio de Janeiro, Brazil
  • Ferreiro, Alejandro, School of Medicine, Montevideo, Uruguay
  • Rosa diez, Guillermo Javier, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  • Lombardi, Raul, Servicio Medico Integral, Montevideo, Uruguay

Group or Team Name

  • On behalf of EPILAT-IRA study group. AKI Committee of the Latin American Society of Nephrology and Hypertension (SLANH)
Background

AKI is a frequent disorder in community-based populations. Most studies have focused on hospital-acquired AKI and very few have explored characteristics and outcomes of patients with community-acquired AKI (CA-AKI). CKD may adversely affect kidney repair and recovery from AKI. We therefore aimed to explore characteristics and outcomes of CA-AKI in patients with and without CKD.

Methods

We conducted a prospective observational study (EPILAT-IRA) within the ER of a University Hospital, screening for any patient ≥16 years. We included patients meeting sCr KDIGO AKI definition over a 9-month period and designated as community acquired. De-identified clinical and lab data was entered in a specifically designed on-line platform. Co-variables potentially linked to AKI were recorded and we analized if there were differences in short and long-term outcomes between patients with and without CKD.

Results

During study period we screened 1,210 patients, CA-AKI incidence was 11.65% (n = 141) most patients were male (55.32%) and the mean age was 67,9±2 years. There were no differences in risk factors between patients with AKI and AKI on CKD. Nephrotoxic drugs were the most common cause of CA-AKI in both groups (AKI 92.2% vs. AKI on CKD 87.2%; p= 0.72) followed by dehydration (AKI 81.3% vs AKI on CKD 76.9%; p 0.65) and systemic disease (AKI 81.3% vs. AKI on CKD 82.0%; p = 0.64). Different outcomes are reported in table.

Conclusion

CA-AKI in developing countries is common and potentially preventable since the two main etiology factors were dehydration and nephrotoxins. Hospital, 90-day and one year mortality were not different between AKI and AKI on CKD; however, RRT requirement was higher and partial recovery of renal function was lower in patients with AKI on CKD which indicates that CKD may adversely affect kidney repair and recovery. Our study provides important information that contributes to a better knowledge of CA-AKI.