Long-Term Outcomes in Patients with Acute Kidney Injury

Abstract

The long-term sequelae of AKI have received increasing attention so that its associations with a number of adverse outcomes, including higher mortality and development of CKD, are now widely appreciated. These associations take on particular importance when considering the high incidence of AKI, with a lack of proven interventions and uncertainties around optimal care provision meaning that the long-term sequelae of AKI present a major unmet clinical need. In this review, we examine the published data that inform our current understanding of long-term outcomes following AKI and discuss potential knowledge gaps, covering long-term mortality, CKD, progression to ESKD, proteinuria, cardiovascular events, recurrent AKI, and hospital readmission.

Keywords: acute kidney injury; attention; cardiovascular diseases; chronic kidney failure; chronic renal insufficiency; clinical nephrology; disease progression; humans; incidence; outcomes; patient readmission; progression of renal failure; proteinuria; renal injury.

Figure 1.

Summary of reported event rates for long term outcomes after AKI. The size of the arrows are a representation of the number of currently available studies reporting this outcome. It should also be noted that, although the rates are reported in the same units (events/100-person-years), data are taken from different sources and are therefore not directly comparable. The superscript letters indicate the sources of the event rates: ^aOdutayo et al. (8); ^bHsu et al. (63); ^cWang et al. (64); ^dBrown et al. (9); ^eHorne et al. (11); and ^fSee et al. (5).