AKI hospitalization correlates with risk of death, rehospitalization
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Key takeaways:
- AKI during hospitalization correlates with increased mortality risk.
- This correlation occurs in both patients with and without chronic kidney disease.
Patients who experience AKI during hospitalization showed an increased risk for 90- and 365-day all-cause and selected-cause rehospitalization and death following discharge, according to data in the American Journal of Kidney Diseases.
“We hope this study leads to a growing awareness about the dramatic increased adverse risks after a hospitalization with AKI – outcomes that could substantially affect health,” Ivonne H. Schulman, MD, program director at National Institute of Diabetes and Digestive and Kidney Diseases, said in a press release. “There currently is no standard of care for people after being hospitalized with AKI, and this information could help get us there.”
In a retrospective study, researchers propensity-score matched data for 471,176 patients hospitalized with AKI to patients hospitalized without AKI between January 2007 and September 2020. Data were derived from Optum Clinformatics.
Researchers used the cumulative incidence function method to determine the rehospitalization and death incidences, then compared the results with Gray’s test. Using Cox models, researchers measured the relationship between AKI and the primary outcomes of all-cause rehospitalization, selected-cause rehospitalization and mortality at 90 and 365 days following index hospitalization. Additionally, researchers conducted overall and stratified analyses to assess the interactions between AKI hospitalizations and preexisting chronic kidney disease.
Ninety days after hospitalization, analyses revealed AKI correlated with increased rates of rehospitalization for any cause, end-stage kidney disease, heart failure, sepsis, pneumonia, myocardial infarction and volume depletion. These results remained consistent at 365 days. According to the prelease, patients with AKI were 62% more likely to experience rehospitalization and 266% more likely to die of any cause within 90 days of discharge.
Researchers identified a higher mortality rate among the group with AKI than in those without it at day 90 and day 365. Overall, the risk of outcomes increased when researchers stratified patients by CKD status.
“Randomized trial evidence is needed to determine whether preventive strategies or interventions given early during AKI can reduce the risks of future adverse kidney and cardiovascular outcomes. The findings in the present study demonstrate that preventive strategies and interventions are necessary in patients with and without preexisting CKD,” Schulman and colleagues wrote. They added, “Although the best post-hospitalization AKI clinical management regimen is yet to be determined, these results underscore the immediate need for close post-hospitalization monitoring of individuals with AKI.”
Reference:
- Being hospitalized with acute kidney injury may increase risk for rehospitalization and death. https://www.nih.gov/news-events/news-releases/being-hospitalized-acute-kidney-injury-may-increase-risk-rehospitalization-death. Published April 27, 2023. Accessed April 27, 2023.
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