Survival and renal recovery after acute kidney injury requiring dialysis outside of intensive care units
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NEPHROLOGY - ORIGINAL PAPER
Survival and renal recovery after acute kidney injury requiring dialysis outside of intensive care units Silvia González Sanchidrián1,2 · Javier L. Deira Lorenzo1 · M. Jimena Muciño Bermejo2,3 · Pedro J. Labrador Gómez1 · Juan R. Gómez‑Martino Arroyo1 · Stefania Aresu2,4 · Enrico Tonini2 · Paolo Armignacco2 · Claudio Ronco2,5 Received: 18 March 2020 / Accepted: 22 June 2020 © Springer Nature B.V. 2020
Abstract Background The incidence of acute kidney injury requiring dialysis (AKI-D) is increasing globally and it is usually associated to chronic kidney disease (CKD) and high mortality. Literature is lacking in short- and intermediate-term data on recovery of renal function after acute kidney injury (AKI). Objectives The objective was to evaluate the overall survival and renal recovery after an episode of AKI requiring dialysis out of intensive care units (ICUs). Materials and methods Retrospective study including patients admitted in two nephrology units along a period of 2 years. Patients admitted to ICUs and renal transplant patients were excluded. Baseline renal function, mortality and glomerular filtration rate (GFR) improvement were evaluated. Results 151 consecutive adult patients with AKI requiring renal replacement therapy (RRT) were included. Mean age was 70.5 ± 15.2 years, 60.3% were males. Median baseline creatinine (bCr) and baseline GFR (bGFR) were 1.4 mg/dL and 46 mL/ min/1.73 m2, respectively. After 1 year of follow-up, we completed the monitoring of 94 patients: 64.9% had died, 10.6% were alive on dialysis and 24.5% were alive without need for RRT. Patients with bGFR > 60 mL/min/1.73 m2 prior to AKI episode had a slower but sustained GFR improvement through the follow-up in comparison with patients with bGFR 60 mL/min/1.73 m2 prior to AKI had a renal recovery closer to the basal renal function than in patients with a previously diminished GFR. Keywords Acute kidney injury (AKI) · Dialysis · Epidemiology · Renal recovery · Survival * Silvia González Sanchidrián [email protected]
Claudio Ronco [email protected]
Javier L. Deira Lorenzo [email protected]
1
M. Jimena Muciño Bermejo [email protected]
Division of Nephrology and Dialysis, San Pedro de Alcántara Hospital, University Hospital Complex of Cáceres, Cáceres, Spain
2
Pedro J. Labrador Gómez [email protected]
International Renal Research Institute of Vicenza (IRRIV), San Bortolo Hospital, Nephrology, Vicenza, Italy
3
Juan R. Gómez‑Martino Arroyo [email protected]
Intensive Care Unit, Clinica Medica Sur Foundation, Ciudad de México, México
4
Stefania Aresu [email protected]
Division of Nephrology and Dialysis, Azienda Ospedaliera G. Brotzu, Cagliari, Italy
5
Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy
Enrico Tonini [email protected] Paolo Armignacco [email protected]
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Abbreviations ACEi/ARB Angiotensin-converting enzyme inhibitor / angiotensin receptor blocker AK
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