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Meta-Analysis
. 2018 Apr 19;19(1):91.
doi: 10.1186/s12882-018-0876-7.

The prognostic importance of duration of AKI: a systematic review and meta-analysis

Swati Mehta  1 , Kinsuk Chauhan  2 , Achint Patel  2 , Shanti Patel  2 , Rachel Pinotti  2 , Girish N Nadkarni  2 , Chirag R Parikh  3 , Steven G Coca  2
Affiliations
Meta-Analysis

The prognostic importance of duration of AKI: a systematic review and meta-analysis

Swati Mehta et al. BMC Nephrol. .

Abstract

Background: Acute kidney injury (AKI), as defined by peak increase in serum creatinine, is independently associated with increased risk of mortality and length of stay. Studies have suggested that the duration of AKI may be an important additional or independent prognostic marker of increased mortality in patients with AKI across clinical settings. We performed a systematic review and meta-analysis of published studies to assess the impact of duration of AKI on outcomes.

Methods: Various bibliographic databases (MEDLINE, Embase, Cochrane Library, CINAHL and Web of Science) were searched through database inception to December 2015. Human, longitudinal studies with patients aged 18 or above describing outcomes of duration of AKI were included. Duration of AKI categorized as "Short" if AKI duration was ≤2 days or labeled as "transient AKI"; "Medium" for AKI durations 3-6 days and "Long" for AKI duration of ≥7 days or "non-recovered". Various outcomes looked at were Long term mortality, cardiovascular events, chronic kidney disease (CKD).

Results: Eighteen studies were deemed eligible for the systematic review. The outcome of long-term mortality with duration of AKI was reported in 8 studies. The pooled Risk Ratio (RR) for long-term mortality generally was higher for longer duration of AKI: short duration of AKI (n = 8 studies, RR 1.42, 95% CI 1.21-1.66), medium duration (n = 4 studies, RR 1.92, 95% CI 1.34-2.75), and long duration (n = 8 studies, RR 2.28, 95% CI 1.77-2.94) duration of AKI. Further, Duration of AKI was independently associated with higher risk of cardiovascular outcomes and incident CKD Stage 3 when stratified within each stage of AKI.

Conclusion: Duration of AKI was independently associated with long term mortality, cardiovascular(CV) events, and development of incident CKD Stage 3.

Keywords: Acute kidney injury; Duration; Mortality.

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Prisma flow diagram of studies that were considered for inclusion
Fig. 2
Fig. 2
Pooled RRs for long term mortality by short (a), medium (b) and long (c) duration of AKI
Fig. 3
Fig. 3
RR for CHF by duration within strata of AKI
Fig. 4
Fig. 4
RR for MI by duration within strata of AKI
Fig. 5
Fig. 5
Risk for incident CKD stage 3 increases with duration even after adjusting for KDIGO stage
See this image and copyright information in PMC

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References

    1. Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005;16:3365–3370. doi: 10.1681/ASN.2004090740. - DOI - PubMed
    1. Liangos O, Wald R, O'Bell JW, Price L, Pereira BJ, Jaber BL. Epidemiology and outcomes of acute renal failure in hospitalized patients: a national survey. Clin J Am Soc Nephrol. 2006;1:43–51. doi: 10.2215/CJN.00220605. - DOI - PubMed
    1. Finkenstaedt JT, Merrill JP. Renal function after recovery from acute renal failure. N Engl J Med. 1956;254:1023–1026. doi: 10.1056/NEJM195605312542203. - DOI - PubMed
    1. Chuasuwan A, Kellum JA. Cardio-renal syndrome type 3: epidemiology, pathophysiology, and treatment. Semin Nephrol. 2012;32:31–39. doi: 10.1016/j.semnephrol.2011.11.005. - DOI - PubMed
    1. James MT, Hemmelgarn BR, Wiebe N, et al. Glomerular filtration rate, proteinuria, and the incidence and consequences of acute kidney injury: a cohort study. Lancet. 2010;376:2096–2103. doi: 10.1016/S0140-6736(10)61271-8. - DOI - PubMed

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