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Abstract: PO0235

Incidence and Prognosis of Different Stages of Acute Kidney Disease: A Single-Center Retrospective Cohort Study

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Chen, Yu-Wei, Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
  • Wu, Mei-Yi, Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
  • Wu, Mai-Szu, Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
Background

The 16th Acute Disease Quality Initiative (ADQI) recommends that the definitions and staging criteria for acute kidney disease (AKD) be congruent with the stage of AKI. To delineate the prognostic values of the AKD staging system, we constructed a large retrospective cohort and evaluated the disparate outcomes among patients with different stages of AKD.

Methods

This study was a retrospective cohort study including 4,741 adult AKI patients in a single tertiary medical center from 2015 to 2018, with at least 1 serum creatinine measurement between 7 to 90 days after AKI. The 16th ADQI recommendations were used to estimate the proportion of patients at different AKD stages (Figure 1). All patients were followed up for 1 year (study end date, Dec 31st, 2019) to analyze risk factors associated with eGFR decline, initiation of dialysis and in-hospital mortality.

Results

Among the 4,741 AKI patients included in the cohort, AKD stages 1-3 after AKI was common (53% in the CKD group and 51% in the non-CKD group). In the logistic regression model adjusted for demographics and comorbidities and after a 1-year follow-up, AKD stages 1/2/3 (AKD stage 0 as reference group) were associated with higher risks of eGFR decline (AKD stage: Odds ratio, 95% Confidence Interval [95% CI], AKD 1: 2.14, 1.65-2.79; AKD 2: 2.64, 2.01-3.47; AKD 3: 2.90, 2.29-3.66), initiation of kidney replacement therapy, (AKD stage: Odds ratio, 95% CI, AKD 2: 1.88, 1.39-2.53; AKD 3: 8.72, 7.07-10.76), and in-hospital mortality (AKD stage: Odds ratio, 95% CI, AKD 1: 1.79, 1.47-2.18; AKD 2: 3.23, 2.65-3.94; AKD 3: 5.59, 4.69-6.67).

Conclusion

Staging criteria for AKD identified AKI patients at higher risk of kidney function decline, dialysis, and mortality. AKD patients with a more severe stage need to receive intensified care.

Funding

  • Government Support – Non-U.S.