Kidney Week

Abstract: FR-PO0126

Is Obstructive Nephropathy a Truly Favourable and Reversible Type of AKI?

Session Information

• AKI: Epidemiology and Clinical Trials
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Acosta-Ochoa, Isabel, Hospital Rio Carrion, Palencia, CL, Spain

Isabel Acosta-Ochoa, MD, PhD

• Sanchez Gil, Jimmy Reinaldo, Hospital General de Fuerteventura, Puerto del Rosario, CN, Spain

Jimmy Reinaldo Sanchez Gil, MD

• Hernández García, Esther, Hospital Rio Carrion, Palencia, CL, Spain

Esther Hernández García, MD

• Oviedo, Victoria, Hospital Rio Carrion, Palencia, CL, Spain

Victoria Oviedo, MD

• Gonzalez, Carmen Calderon, Hospital Rio Carrion, Palencia, CL, Spain

Carmen Calderon Gonzalez, DrMed

• Ampuero, Karina, Hospital Rio Carrion, Palencia, CL, Spain

Karina Ampuero, MD

• Velasco, Rubén, Hospital Rio Carrion, Palencia, CL, Spain

Rubén Velasco, MD

• Martinez, Maria, Hospital Clinico Universitario de Valladolid Servicio de Cardiologia, Valladolid, CL, Spain

Maria Martinez

• Coca, Armando, Hospital Clinico Universitario de Valladolid Servicio de Cardiologia, Valladolid, CL, Spain

Armando Coca, MD, MPH

Background

Obstructive AKI (ObAKI) constitutes 10% of AKI cases. Renal damage is caused by ischemic-inflammatory factors that cause fibrosis. Tubular functions like fluid handling and acid-base balance are affected, resulting in oligoanuria and acidosis. Diagnosis is confirmed by imaging. Management relies on drainage of the urinary tract and supportive measures. Few studies compare the occurrence of adverse outcomes and rate of renal recovery between ObAKI and other etiologies

Methods

Retrospective, observational study, 3 hospitals (1 island territory), during 4 years, of patients with AKI by KDIGO guidelines. Cohort was divided in ObAKI and other etiologies. Adverse events definition: need for HD, HD dependence and in-hospital death. We analyzed LOS, time to consultation and rate of recovery (defined as SCr at discharge ≤1.4x baseline, HD dependence and death: not recovery)

Results

We included 2897 AKI episodes that occurred in 1537 individuals, 292 (10.1%) in ObAKI group. They were older and had a higher male proportion. They showed a higher CCI, but less HTN and DM, no differences in CKD. They were admitted less frequently to the ICU and more in Qx wards. Their mean Max-SCr was higher. ObAKI was more frequently community-acquired, suffered less Stage 1, more Stage 3, Table-A. In adverse outcomes, ObAKI patients had shorter LOS, and time to consultation. They needed acute HD less frequently, with no significant differences in HD dependence and death, nor in the rate of renal recovery, Table-B

Conclusion

We observed an incidence of 10% of ObAKI. Despite requiring less frequently acute HD, there are no differences in the rates of HD dependence and mortality, and no differences in recovery rate between groups. More than half of ObAKI group requiring acute HD were HD dependent at discharge. The idea that SCr restoration occurs, and therefore ObAKI is a transient cause of AKI, with total recovery; however, our results show that ObAKI does not offer a survival advantage or recovery and should be addressed and followed closer

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20250m5aqhw6