Predictors of Recurrent Acute Kidney Injury Identified

Risk factors include longer duration of AKI and hospitalization for congestive heart failure, acute coronary syndrome, and decompensated advanced liver disease.
Risk factors include longer duration of AKI and hospitalization for congestive heart failure, acute coronary syndrome, and decompensated advanced liver disease.

Researchers have identified clinical predictors of recurrent acute kidney injury (AKI), findings they say could aid in risk-stratifying AKI patients, guide appropriate patient referral following AKI, and help develop potential risk reduction strategies, according to a report in the Journal of the American Society of Nephrology (published online ahead of print).

In a study of 11,683 hospitalized patients with AKI, researchers found that the risk of being hospitalized for recurrent AKI was highest among those with longer AKI duration and those hospitalized with a primary diagnosis of congestive heart failure, decompensated advanced liver disease, cancer with or without chemotherapy, acute coronary syndrome, or volume depletion, Edward D. Siew, MD, of Vanderbilt University in Nashville, Tenn., and colleagues reported.

“The risk for recurrent AKI is likely to be due both to intrinsic susceptibility, which may increase after an episode of AKI, as well as the risk conferred by the residual effects of acute illness or its therapies,” the authors concluded. These factors are critical considerations in caring for recent AKI survivors.”

Of the 11,683 patients, 2,954 (25%) were hospitalized with recurrent AKI within 12 months of discharge. The median time to recurrent AKI within 12 months was 64 days. Patients who experienced recurrent AKI were older than those who did not (71 vs. 67 years). They also had a heavier co-morbidity burden. For example, diabetes mellitus and hypertension were, respectively, present in 60% and 88% of patients who had recurrent AKI compared with 52% and 85% of those who did not.

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