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Kidney Week

Abstract: FR-PO112

Long-Term Outcome of AKI: New-Onset Comorbidities and Survival

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Choi, Young Eun, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Yang, Jihyun, Kangbuk Samsung Medical Center, Jongno-gu, Korea (the Republic of)
  • Kim, Sungyeon, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Chung, Suk Min, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Yoon Sook, Ko, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Hee Young, Lee, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Fang, Yina, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Koo, Tai yeon, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Oh, Sewon, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Kim, Myung-Gyu, Korea University Anam Hospital, Seoul, Korea (the Republic of)
  • Jo, Sang-Kyung, Korea University Anam Hospital, Seoul, Korea (the Republic of)
Background

Acute kidney injury (AKI) is known as a risk factor for short-term mortality and poor prognosis. In this study, we studied whether the AKI would be a risk factor for other comorbidities using the Korean national medical insurance database.

Methods

This study was performed using data from NHIS-NSC of Korea. The cohort was composed of 0.4% of the total eligible Korean population baseline population (n=186,512 AKI patients vs 45,000,000) between 2008 to 2013. We set that inclusion period as the index date. Patients who had been diagnosed with AKI using N17 code and dialysis requiring AKI (AKI-D) were defined as patients who were encoded with dialysis-related codes, the rest of the patients who had experienced AKI without a history of dialysis were defined as AKI-non-D. Patients with a previous history of AKI, end-stage kidney disease (ESKD), and dead before the index date were excluded.

Results

During a median follow-up of 1800days, newly developed comorbidities including angina, myocardial infarction, cardiac failure, cerebral hemorrhage and cerebral infarction, percutaneous coronary artery intervention, coronary artery bypass graft, fractures, and dementia were observed in AKI-D survivors. Survivors of AKI regardless of AKI severity showed higher mortality compared to the normal population. Patients with AKI-D showed worse survival compared with AKI-non-D as well as ESKD. Most of the initial mortality drop was observed within 300 days. Female, elderly with coexisting comorbidities including hypertension, angina, cardiac failure, cerebral hemorrhage and infarction, malignancy, fracture history, and dementia were significant risk factors for mortality.

Conclusion

AKI episode has long-term adverse effects on comorbidities and poor survival which is worst with dialysis-requiring cases. Close monitoring for renal function with comorbidity management would be important to severe AKI survivors.