AKI linked to readmission, mortality after hospital discharge
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Hospital admission with an AKI diagnosis increases the risk for death, hospitalization, heart failure, pneumonia and sepsis after hospital discharge, according to results presented at ASN Kidney Week.
“These findings highlight the need for early interventions to mitigate the significant morbidity and mortality burden associated with an AKI event in patients with and without [chronic kidney disease] CKD,” Ivonne H. Schulman, MD, of the NIH, said.
In the retrospective, propensity-matched study, Schulman and colleagues studied the association between first AKI hospitalization, which did not require dialysis after discharge, with death and all-cause rehospitalizations 90 days and 1 year after an AKI event. Researchers used the Optum Clinformatics database to identify 594,509 hospitalized patients with AKI and 594,509 hospitalized patients without AKI from January 2002 to September 2020. Patients were matched for age, sex, race/ethnicity and preexisting CKD and heart failure. Mean patient age was 74.1 years.
Overall, 55.9% of patients in the AKI cohort and 26.5% of patients in the non-AKI group were hospitalized during the 2 years prior to index hospitalization. Additionally, 50.3% of patients in the AKI cohort had CKD and 34.9% had heart failure, which was similar to patients in the non-AKI cohort.
Schulman and colleagues found patients who were hospitalized with AKI had a higher risk of sepsis, heart failure, recurrent AKI, pneumonia, cerebrovascular accident and heart attack within 90 days and 1 year after hospital discharge compared with patients in the non-AKI cohort.
“Sepsis, heart failure and recurrent AKI were the primary causes of rehospitalization with the highest cumulative incidence at 90 days and 1 year in AKI patients and were significantly more common in patients with AKI than in those without AKI,” she said.
Mortality rates were higher for patients in the AKI cohort compared with patients in the non-AKI cohort at 90 days and 1 year, according to study results.
“While the best post-AKI clinical management regimen is yet to be determined, these results underscore the immediate need for close post-hospitalization monitoring of individuals with AKI,” Schulman said.
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Schulman IH, et al. Paper TH-OR06. Presented at: ASN Kidney Week; Nov. 4-7, 2021 (virtual meeting).
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