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The risk of chronic kidney disease and mortality are increased after community-acquired acute kidney injury

2016-11Journal article Restricted access
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dc.contributor.authorSoto, Karina
dc.contributor.authorCampos, Pedro
dc.contributor.authorPinto, Iola
dc.contributor.authorRodrigues, Bruno
dc.contributor.authorFrade, Francisca
dc.contributor.authorPapoila, Ana Luisa
dc.contributor.authorDevarajan, Prasad
dc.date.accessioned2017-07-17T11:31:10Z
dc.date.available2017-07-17T11:31:10Z
dc.date.issued2016-11
dc.description.abstractWe investigated whether community-acquired acute kidney injury encountered in a tertiary hospital emergency department setting increases the risk of chronic kidney disease (CKD) and mortality, and whether plasma biomarkers could improve the prediction of those adverse outcomes. In a prospective cohort study, we enrolled 616 patients at admission to the emergency department and followed them for a median of 62.1 months. Within this cohort, 130 patients were adjudicated as having acute kidney injury, 159 transient azotemia, 15 stable CKD, and 312 normal renal function. Serum cystatin C and plasma neutrophil gelatinase-associated lipocalin (NGAL) were measured at index admission. After adjusting for clinical variables, the risk of developing CKD stage 3, as well as the risk of death, were increased in the acute kidney injury group (hazard ratio [HR],5.7 [95% confidence interval, 3.8–8.7] and HR, 1.9 [95% confidence interval, 1.3–2.8], respectively). The addition of serum cystatin C increased the ability to predict the risk of developing CKD stage 3, and death (HR, 1.5 [1.1–2.0] and 1.6 [1.1–2.3], respectively). The addition of plasma NGAL resulted in no improvement in predicting CKD stage 3 or mortality (HR,1.0 [0.7–1.5] and 1.2 [0.8–1.8], respectively). The risk of developing CKD stage 3 was also significantly increased in the transient azotemia group (HR, 2.4 [1.5–3.6]). Thus, an episode of community acquired acute kidney injury markedly increases the risk of CKD, and moderately increases the risk of death. Our findings highlight the importance of follow-up of patients with community acquired acute kidney injury, for potential early initiation of renal protective strategiespt_PT
dc.description.sponsorshipP50DK096418
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSOTO, Karina [et al] - The risk of chronic kidney disease and mortality are increased after community-acquired acute kidney injury. Kidney International. ISSN 0085-2538. Vol. 90, N. º5, (2016), pp. 1090-1099pt_PT
dc.identifier.doi10.1016/j.kint.2016.07.018pt_PT
dc.identifier.issn0085-2538
dc.identifier.issn1523-1755
dc.identifier.urihttp://hdl.handle.net/10400.21/7273
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectAcute kidney injurypt_PT
dc.subjectBiomarkerspt_PT
dc.subjectChronic kidney diseasept_PT
dc.subjectCystatin Cpt_PT
dc.subjectNGALpt_PT
dc.titleThe risk of chronic kidney disease and mortality are increased after community-acquired acute kidney injurypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1099pt_PT
oaire.citation.issue5pt_PT
oaire.citation.startPage1090pt_PT
oaire.citation.titleKidney Internationalpt_PT
oaire.citation.volume90pt_PT
person.familyNameSoto
person.familyNamePinto
person.familyNamePapoila
person.familyNameDevarajan
person.givenNameKarina
person.givenNameIola
person.givenNameAna Luisa
person.givenNamePrasad
person.identifierR-000-ME5
person.identifier.ciencia-id4E18-50D1-9D7C
person.identifier.ciencia-id5715-2B2D-9ADC
person.identifier.ciencia-id251C-0273-1068
person.identifier.orcid0000-0002-6977-9361
person.identifier.orcid0000-0002-2945-1441
person.identifier.orcid0000-0002-2918-8364
person.identifier.orcid0000-0002-7847-8552
person.identifier.ridS-2515-2016
person.identifier.scopus-author-id6602688141
person.identifier.scopus-author-id34969436900
person.identifier.scopus-author-id6507532321
person.identifier.scopus-author-id35400868900
rcaap.rightsclosedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication9be31923-4703-4aac-98b1-6cd617d78658
relation.isAuthorOfPublication137d7dcc-401e-4d4a-862f-1d955c6f7257
relation.isAuthorOfPublication287e5ccb-e43a-42c7-a632-df8b2b0fd985
relation.isAuthorOfPublicationc15c111a-10a9-4255-914f-a25a71415230
relation.isAuthorOfPublication.latestForDiscovery137d7dcc-401e-4d4a-862f-1d955c6f7257

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