PMID- 26660951
OWN - NLM
STAT- MEDLINE
DCOM- 20170313
LR  - 20220321
IS  - 1440-1797 (Electronic)
IS  - 1320-5358 (Linking)
VI  - 21
IP  - 12
DP  - 2016 Dec
TI  - Improved long-term survival and renal recovery after acute kidney injury in 
      hospitalized patients: A 20 year experience.
PG  - 1027-1033
LID - 10.1111/nep.12698 [doi]
AB  - AIM: Acute kidney injury (AKI) is a common complication of medical and surgical 
      interventions in hospitalized patients and associates with high mortality. Our 
      aim was to examine renal recovery and long-term survival and time trends in AKI 
      survival. METHODS: Changes in serum creatinine (SCr) were used to define AKI in 
      patients at Landspitali University Hospital in Iceland from 1993 to 2013. Renal 
      recovery was defined as SCr < 1.5x baseline. RESULTS: Out of 25 274 individuals 
      who had their highest measured SCr during hospitalization and an available 
      baseline SCr, 10,419 (41%) had AKI during hospitalization (H-AKI), 19%, 11% and 
      12% with Stage 1, 2 and 3, respectively. The incidence of H-AKI increased from 
      18.6 (95% CI, 14.7-22.5) to 29.9 (95% CI, 26.7-33.1) per 1000 admissions/year 
      over the study period. Survival after H-AKI was 61% at 90-days and 51% at one 
      year. Comparing H-AKI patients to propensity score matched individuals the hazard 
      ratio for death was 1.49 (1.36-1.62), 2.17 (1.95-2.41) and 2.95 (2.65-3.29) for 
      Stage 1, 2 and 3, respectively. One-year survival of H-AKI patients improved from 
      47% in 1993-1997 to 57% in 2008-2013 and the adjusted hazard ratio for mortality 
      improved, compared to the first 5-year period, 0.85 (0.81-0.89), 0.67 
      (0.64-0.71), and 0.57 (0.53-0.60) for each subsequent 5-year interval. Recovery 
      of renal function was achieved in 88%, 58% and 44% of patients in Stages 1, 2 and 
      3, respectively, improving with time. CONCLUSIONS: Acute kidney injury is an 
      independent predictor of long-term mortality in hospitalized patients but there 
      has been a marked improvement in survival and renal recovery over the past two 
      decades.
CI  - (c) 2015 Asian Pacific Society of Nephrology.
FAU - Long, Thorir E
AU  - Long TE
AD  - Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
AD  - Internal Medicine Services, Iceland.
FAU - Sigurdsson, Martin I
AU  - Sigurdsson MI
AD  - Department of Anesthesia and Intensive Care, Reykjavik, Iceland.
AD  - Department of Anesthesia, Perioperative and Pain Medicine, Brigham and Women s 
      Hospital / Harvard Medical School, Boston, MA, United States.
FAU - Sigurdsson, Gisli H
AU  - Sigurdsson GH
AD  - Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
AD  - Department of Anesthesia and Intensive Care, Reykjavik, Iceland.
FAU - Indridason, Olafur S
AU  - Indridason OS
AD  - Internal Medicine Services, Iceland.
AD  - Division of Nephrology, Landspitali - The National University Hospital of 
      Iceland, Reykjavik, Iceland.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - Australia
TA  - Nephrology (Carlton)
JT  - Nephrology (Carlton, Vic.)
JID - 9615568
RN  - 0 (Biomarkers)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
CIN - Nephrology (Carlton). 2017 Sep;22(9):733. PMID: 28792129
MH  - Acute Kidney Injury/blood/mortality/physiopathology/*therapy
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers/blood
MH  - Chi-Square Distribution
MH  - Creatinine/blood
MH  - Female
MH  - Humans
MH  - Iceland/epidemiology
MH  - Incidence
MH  - *Inpatients
MH  - Kaplan-Meier Estimate
MH  - Kidney/*physiopathology
MH  - Kidney Function Tests
MH  - Male
MH  - Middle Aged
MH  - Propensity Score
MH  - Proportional Hazards Models
MH  - Recovery of Function
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Acute kidney injury
OT  - epidemiology
OT  - outcome
OT  - propensity score matching
OT  - renal recovery
OT  - survival
EDAT- 2015/12/15 06:00
MHDA- 2017/03/14 06:00
CRDT- 2015/12/15 06:00
PHST- 2015/10/12 00:00 [received]
PHST- 2015/11/22 00:00 [revised]
PHST- 2015/12/07 00:00 [accepted]
PHST- 2015/12/15 06:00 [pubmed]
PHST- 2017/03/14 06:00 [medline]
PHST- 2015/12/15 06:00 [entrez]
AID - 10.1111/nep.12698 [doi]
PST - ppublish
SO  - Nephrology (Carlton). 2016 Dec;21(12):1027-1033. doi: 10.1111/nep.12698.