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Kidney Week

Abstract: PO0232

The Clinical Characteristics of Inpatients with AKI and the Risk Factors for Progression to CKD

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Xu, Lingling, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
  • Zhou, Yang, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
  • Yang, Junwei, Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
Background

To explore the incidence of AKI in hospitalized patients and demonstrate the distributions and clinical characteristics of AKI and the risk factors for progression to CKD.

Methods

Medical records of inpatients were acquired from Nanjing Health Information Platform from January 1 to December 31, 2019. A total of 20258 patients with 2 or more serum creatinine records during one single hospitalization were enrolled. We analyzed the distribution, clinical features, and associated risk factors of AKI. A prospective cohort of 999 AKI patients was followed up for a medium of one year. Multivariable logistic regression was used to analyze the risk factors for the progression from AKI to CKD and a risk predictive model was established accordingly.

Results

Among the enrolled patients, 2194 (10.8%) developed AKI in this study. The prevalence of AKI in medical department, surgical department and ICU were 9.1%, 10.5% and 27.9%, respectively. Compared with the non-AKI group, there were more men and elderly in the AKI group. Patients with AKI were more likely to be complicated with diabetes, hypertension, and CKD. The baseline serum creatinine, uric acid, fasting blood glucose and inflammatory biomarker in AKI group were significantly higher than those in non-AKI group. On the contrary, those with AKI had lower blood lipids, albumin and hemoglobin. The presence of AKI predicted a significant increase in hospitalization cost, duration and all-cause mortality. Furthermore, 110 individuals (11.0%) progressed to CKD in the prospective cohort. Age, AKI stage, hypertension, baseline serum creatinine, uric acid and hemoglobin were found to be independent risk factors for progression to CKD. A risk predictive model of progression from AKI to CKD was established with an area under the ROC curve of 0.822 (95%CI 0.788 ~ 0.877, P < 0.001).

Conclusion

Age, AKI stage, baseline serum creatinine, hypertension, hyperuricemia and hypo-hemoglobinemia were independent risk factors for the progression of CKD in AKI patients. Predictive model established using these variables can help us screen those high-risk populations.

Funding

  • Government Support – Non-U.S.