Baseline, post-acute kidney function key in evaluating patients with AKI needing dialysis
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Key takeaways:
- All-cause mortality was 28.3% during a mean of 1.2 years follow-up in the study cohort.
- Incidence rate of major adverse cardiac events was 11.1%.
Measuring baseline and post-acute kidney function is key in evaluating the risk of adverse outcomes in patients requiring dialysis, according to a nationwide cohort study.
“Unlike AKI and [chronic kidney disease] ... [acute kidney disease] AKD is a relatively novel entity, and the association between the severity of AKD and outcomes is currently unclear,” Heng-Chih Pan, MD, of the College of Medicine at National Taiwan University in Taipei, and colleagues wrote. There is a need to monitor patients with kidney disease to “determine when kidney function status may play a role in the assessment of adverse outcomes.”
Researchers studied 6,703 adults (mean age; 68 years) who had AKI requiring dialysis (AKI-D) with post-AKD kidney function follow-up and AKD stage data. The population-based study used data from health care settings in Taiwan to find the impact of baseline kidney function, AKD severity and kidney function post-AKD on results.
All-cause mortality and incident major adverse cardiac events (MACEs) were main outcomes, followed by permanent dialysis and readmission.
Baseline and post-AKD kidney function were significant independent factors “associated with the long-term prognosis of patients with AKI-D,” the researchers wrote. Each was linked with all-cause mortality, MACEs, end-stage kidney disease and readmission. “Concerted efforts to understand the transition from post-AKD to [CKD] are crucial,” they wrote.
Researchers found an all-cause mortality rate of 28.3% at mean of 1.2 years follow-up. Incidence rates of MACEs and ESKD were 11.1% and 16.7%, respectively. Worse post-AKD function correlated with an increased risk of adverse outcomes, according to the results. AKD severity was not associated with adverse outcomes.
“Stratifying patients with AKI-D by post-AKD and baseline kidney function can improve prognostic prediction along with objective information in clinical practice,” Pan and colleagues wrote. “Coordination of care to reduce post-AKD CKD transition is important.”
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