Kidney Week

Abstract: FR-PO079

Epidemiology and Long-Term Outcomes of Severe AKI in Thailand: A Prospective Multicenter Study

Session Information

• AKI: Epidemiology, Risk Factors, Prevention
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology‚ Risk Factors‚ and Prevention

Authors

• Tangchitthavorngul, Suri, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand

Suri Tangchitthavorngul,

• Lumlertgul, Nuttha, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand

Nuttha Lumlertgul,

• Peerapornratana, Sadudee, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand

Sadudee Peerapornratana,

• Nimkietkajorn, Veerapatr, Buddhachinaraj Phitsanulok Hospital, Phitsanulok, Phitsanulok, Thailand

Veerapatr Nimkietkajorn,

• Oranrigsupak, Petchdee, Nan Hosital, Nan, Nan, Thailand

Petchdee Oranrigsupak,

• Pongsitisak, Wanjak, Division of Nephrology, Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand

Wanjak Pongsitisak,

• Tangvoraphonkchai, Kamonwan, Department of Medicine, Mahasarakham University Hospital, Mahasarakham, Thailand

Kamonwan Tangvoraphonkchai,

• Aksornrat, Atchara, Sichon Hospital, Nakhon Si Thammarat, Thailand

Atchara Aksornrat,

• Intarak, Sompote, Mahasarakham Hospital, Maha Sarakham, Maha Sarakham, Thailand

Sompote Intarak,

• Sukmark, Theerapon, Thungsong Hospital, Nakhon Si Thammarat, Thailand

Theerapon Sukmark,

• Chuasuwan, Anan, Bhumibol Adulyadej Hospital, Bangkok, Bangkok, Thailand

Anan Chuasuwan,

• Khositrangsikun, Kamol, Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat, Nakhon Si Thammarat, Thailand

Kamol Khositrangsikun,

• Parapiboon, Watanyu, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Nakhon Ratchasima, Thailand

Watanyu Parapiboon,

• Tantiyavarong, Pichaya, Thammasat University Hospital, Pathum Thani, Thailand

Pichaya Tantiyavarong,

• Surasit, Karjbundid, Nakornping Hospital, Chiang Mai, Thailand

Karjbundid Surasit,

• Eiam-Ong, Somchai, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand

Somchai Eiam-Ong,

• Srisawat, Nattachai, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand

Nattachai Srisawat,

Background

Acute kidney injury (AKI) contains a high short-term morbidity and mortality. However, little is known regarding long-term outcomes, especially in the resource constrained settings. We aimed to evaluate 1-year major adverse kidney events (MAKE₃₆₅) in patients with severe (stage 3) AKI by kidney recovery patterns at 28 days or hospital discharge.

Methods

We analyzed the data from InSEA RRT registry—a multicenter prospective cohort study conducted between January 2021 and January 2022. Critically ill patients with stage 3 AKI as defined by KDIGO were enrolled and classified by recovery status after 28 days or at hospital discharge as early, late, and nonrecovery. Primary outcome was MAKE₃₆₅ which is a composite of persistent kidney dysfunction, long-term dialysis, and all-cause mortality on day 365 after enrollment.

Results

A total of 1,534 patients from 14 hospitals across Thailand were enrolled. Among these, 755 (49%) patients died, 401 (51%) patients experienced early recovery, 188 (24%) late recovery, and 190 (24%) never reversed AKI. The incidence of MAKE₃₆₅was 68.4 per 100 person-years of all patients. Nonrecovery were more likely to develop MAKE₃₆₅ than recovery (adjusted HR 4.24 ;95% CI, 3.20-5.61; P<0.001). The incidence of new CKD and CKD progression were 82.8 and 42 per 100 person-years. Patients with older, cancer, mixed ICU, and no nephrologist follow-up were also at risk for MAKE₃₆₅.

Conclusion

Nonrecovery AKI was independently associated with adverse long-term outcomes. Recognition and close follow-up of patients with non-recovered AKI is crucial. Novel intervention might improve long-term outcomes and need further study.

Funding

• Private Foundation Support