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. 2019 Dec 14;8(12):2215.
doi: 10.3390/jcm8122215.

The Incidence of Chronic Kidney Disease Three Years after Non-Severe Acute Kidney Injury in Critically Ill Patients: A Single-Center Cohort Study

Sébastien Rubin  1 , Arthur Orieux  1 , Benjamin Clouzeau  2 , Claire Rigothier  1 , Christian Combe  1 , Didier Gruson  2 , Alexandre Boyer  2
Affiliations

The Incidence of Chronic Kidney Disease Three Years after Non-Severe Acute Kidney Injury in Critically Ill Patients: A Single-Center Cohort Study

Sébastien Rubin et al. J Clin Med. .

Abstract

The risk of chronic kidney disease (CKD) following severe acute kidney injury (AKI) in critically ill patients is well documented, but not after less severe AKI. The main objective of this study was to evaluate the long-term incidence of CKD after non-severe AKI in critically ill patients. This prospective single-center observational three-years follow-up study was conducted in the medical intensive care unit in Bordeaux's hospital (France). From 2013 to 2015, all patients with severe (kidney disease improving global outcomes (KDIGO) stage 3) and non-severe AKI (KDIGO stages 1, 2) were enrolled. Patients with prior eGFR < 90 mL/min/1.73 m2 were excluded. Primary outcome was the three-year incidence of CKD stages 3 to 5 in the non-severe AKI group. We enrolled 232 patients. Non-severe AKI was observed in 112 and severe AKI in 120. In the non-severe AKI group, 71 (63%) were male, age was 62 ± 16 years. The reason for admission was sepsis for 56/112 (50%). Sixty-two (55%) patients died and nine (8%) were lost to follow-up. At the end of the follow-up the incidence of CKD was 22% (9/41); Confidence Interval (CI) 95% (9.3-33.60)% in the non-severe AKI group, tending to be significantly lower than in the severe AKI group (44% (14/30); CI 95% (28.8-64.5)%; p = 0.052). The development of CKD three years after non-severe AKI, despite it being lower than after severe AKI, appears to be a frequent event highlighting the need for prolonged follow-up.

Keywords: acute kidney injury; chronic kidney disease; critically ill patients; end stage renal disease; renal recovery.

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Conflict of interest statement

All authors declare that they have no relevant financial interests.

Figures

Figure 1
Figure 1
Flow chart. CKD: chronic kidney disease; AKI: acute kidney injury.
Figure 2
Figure 2
Patients’ survival rate. Renal survival was assessed in 232 patients. The three years renal survival was 43% in the non-severe AKI group and 32% in the severe AKI group with statistical difference. Comparison of renal survival rate using log-rank test.
See this image and copyright information in PMC

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