Abstract: SA-PO142
Clinical Characteristics and Prognosis of Patients with Community-Acquired AKI Compared with Hospital-Acquired AKI: A Meta-Analysis
Session Information
- AKI: Epidemiology, Risk Factors, Prevention - III
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Huang, Linxi, Division of Nephrology, Kidney Institute of CPLA, Changzheng Hospital, Second Military Medical University, Shanghai, China
- Xue, Cheng, Shanghai Changzheng Hospital, Shanghai, China
- Xu, Jing, Shanghai Changzheng Hospital, Shanghai, China
- Mao, Zhiguo, Changzheng Hospital, Shanghai, SHanghai, China
Background
The difference between hospital-acquired acute kidney injury (HA-AKI) and community-acquired AKI (CA-AKI) was inconclusive. We conducted a meta-analysis to summarize and quantify the meaningful diversities between CA-AKI and HA-AKI.
Methods
We identified observational studies reporting clinical characteristics and prognosis between HA-AKI and CA-AKI. Odds ratios (ORs) and mean differences (MD) were extracted for outcomes as mortality, oliguria, ICU risk, dialysis risk, hospital stay and renal recovery.
Results
Fourteen eligible studies were finally included, involving 43,949 patients: 21,418 CA-AKI patients and 22,531 HA-AKI patients. The mortality was significantly lower in CA-AKI patients than HA-AKI: 13.45%vs. 16.17% (OR 0.41, 95%CI 0.34-0.49). Oliguria incidence was lower in CA-AKI patients (OR 0.58, 95%CI 0.38-0.88). ICU was less required in CA-AKI patients (OR 0.24, 95%CI 0.14-0.40). CA-AKI patients were associated with a shorter hospital time (MD -10.08, 95%CI -15.44- -4.73). The renal recovery rate of the two groups’ patients did not show a significant difference (OR 1.26, 95%CI 0.46-3.48). Dialysis need between the two groups was similar (OR 0.99, 95%CI 0.75-1.30).
Conclusion
CA-AKI showed better clinical manifestations with lower oliguria incidence, shorter hospital time and less risk of ICU treatment. The mortality of CA-AKI was lower compared to HA-AKI, indicating a better prognosis; whereas the renal recovery denoted no significant difference between the two groups. Further studies should be conducted to provide more evidence on the time, dose and prognosis for dialysis.
Funding
- Government Support - Non-U.S.