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Kidney Week

Abstract: PO0090

Early Nephrologist Interventions to Avoid Kidney Replacement Therapy in AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Flores, Christian Perez, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Maggiani, Pablo, Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico City, Mexico
  • Chavez, Jonathan, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Font, Jorge Jaime, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Navarro gallardo, Joana Goretty, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Martinez murillo, Noe, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Torres, Jose Antonio, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
  • Gómez Fregoso, Juan, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
Background

Is well know that early nephrologist involvement in patients with AKI improve outcomes. Determine which intervention has a greater impact on avoiding the need for KRT will be an important advance.

Methods

Our objective was to Identify which nephrologist intervention decrease the need of KRT. We analyze age, gender, comorbid conditions, cause of AKI, pharmacology therapy, cause of KRT, early interventions: fluid, antibiotic and nutritional adjustment, nephrotoxic withdrawal and removal of hyperchloremic solutions and death. Kaplan Meier survival analysis. Multivariable logistic regression model was performed. P< 0.05 which is significant.

Results

From 2017 to 2020 288 patients with AKI where analyzed prospectively with a 10 days follow-up, 45 (15%) patients die, overall survival of 84.4% (IC 95% 0.80 – 0.88) (Figure1). Only fluid adjustment decreases the risk of KRT (OR 0.74, 95% CI 0.68-0.81, p < 0.001) while having AKI KDIGO 3 increases the risk (OR 1.12, 95% CI 1.05-1.20, p < 0.001) being the fluid overload the main cause of KRT (OR 1.67, 95% CI 1.53-1.82, p < 0.001). Between all interventions, just fluid adjustment avoid progression to AKI KDIGO 3 (OR 0.76, 95% CI 0.65-0.89, p < 0.001). (Table1)

Conclusion

In AKI, fluid adjustment was the most important nephrologist intervention to avoid KRT.