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Kidney Week

Abstract: FR-PO111

Clinical Characteristics and Outcomes in AKI in Non-Critically Ill Patients

Session Information

  • AKI: Outcomes, RRT
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Fiorentino, Marco, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
  • Nestola, Sebastiano, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
  • Gesualdo, Loreto, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
Background

Although many studies have been focused on critically ill patients in ICUs, AKI occurs even in non-critical care settings. Epidemiological data of AKI outside the ICU are not well investigated. We aim to describe main features and outcomes of AKI in non-critically ill patients in our teaching hospital.

Methods

We performed a retrospective analysis including AKI patients referred to nephrology consultation in a 6-month period at AOU Policlinico, Bari, Italy. We analyzed the main features of AKI episodes, including AKI stages, the need for dialysis, mortality rate and factors associated to kidney function recovery (KFR).

Results

Among 899 patients referred for nephrologists, 415 (46%) were evaluated for AKI. 52.5% of AKI episodes were classified as KDIGO Stage 3, and 54 patients (13%) required RRT. In-hospital mortality was 36.9%, higher in patients with pre-existing CKD, in patients with stage 3 AKI and among those who did not present KRF. Cox analysis showed a higher mortality risk for older age (HR 1.032, 95%CI 1.012–1.053, p=0.002) and pre-renal AKI (HR 2.823, 95%CI 1.219-6.536, p=0.015), while KFR was associated to lower mortality (HR 0.246, 95%CI 0.098-0.615, p=0.003). KFR was observed in 197 patients (47.5%) mainly in patients with mild AKI (stage 1 62.6% vs stage 2 57.6% vs stage 3 36.8%, p<0.001). Higher baseline eGFR (OR 1.025, 95%CI 1.014-1.036, p<0.001) was associated with KFR. Severe AKI was independently associated with lower probability of KFR (OR 0.420, 95%CI 0.248-0.711, p=0.001).

Conclusion

AKI episodes outside the ICU are severe and associated with a high mortality rate even outside the ICU. A timely nephrologist consultation is important to limit AKI severity.

In-hospital survival curve stratified according to baseline eGFR (a), severity of AKI (b) and kidney function recovery (c)