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Kidney Week

Abstract: PO0018

The Spectrum of Biopsy-Proven Kidney Diseases in 2027 Patients with AKI

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Abuduwupuer, Zulihumaer, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Liang, Shao-shan, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Xu, Feng, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Liang, Dandan, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Yang, Xue, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Zhu, Ying, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Liu, Zhihong, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Zeng, Cai-hong, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
Background

Acute kidney injury (AKI) is a group of highly heterogeneous, complicated clinical syndrome. The kidney biopsy plays an irreplaceable role in the evaluation of patients with unexplained AKI and may offer fresh insights into disease heterogeneity. Hence, in this study we aim to analyze the pathological disease spectrum, etiology, and renal recovery of biopsy-proven AKI patients.

Methods

We retrospectively analyzed the clinical and pathological data of AKI patients who went to a kidney biopsy during the hospitalization at our center from January 2013 to December 2018. We classified included patients into pure AKI and ACKD two groups.

Results

The study included 2027 AKI patients who had undertaken renal biopsy, which accounting for 6.8% of the total renal biopsy cases and 31.7% of the total hospitalized AKI cases during the same period. The majority of AKI patients were male (65.1%), with an average age of 42±16.5 years, pure AKI and ACKD account for 21.6% and 78.4%.%. Pure AKI mainly presented as AKI-3 (74.8%), while ACKD mostly presented as AKI-1 (53.5%). The proportion of patients undergoing renal replacement therapy in pure AKI group was significantly higher than ACKD group (29.3% vs 11.9%, P <0.001).) In pure AKI group, acute interstitial nephritis (AIN) was most common (56.1%), followed by acute tubular necrosis (ATN) (34.6%). The main cause of AIN was due to drugs (84.9%) and the main causes of ATN were infections (41.7%) (epidemic hemorrhagic fever) and drugs (38.4%). In ACKD group, primary and secondary glomerular disease accounted for 70.6%.and 26.9%, and the most frequent pathological disease were IgAN, followed by MCD, FSGS, MN, LN, AAV. Among the followed-up patients the proportions of complete, partial and non-renal recovery were 73.2%, 13.3% and 13.5%, respectively.

Conclusion

Among biopsy-proven AKI patients, pure AKI was relatively rare while ACKD accounts for the majority. Pure AKI tend to be more serious than ACKD and more patients required dialysis. ACKD patients had a wide spectrum of pathological diseases, and the prognosis of renal recovery was worse than pure AKI.

Funding

  • Private Foundation Support