Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.21/7273
Título: The risk of chronic kidney disease and mortality are increased after community-acquired acute kidney injury
Autor: Soto, Karina
Campos, Pedro
Pinto, Iola
Rodrigues, Bruno
Frade, Francisca
Papoila, Ana Luísa
Devarajan, Prasad
Palavras-chave: Acute kidney injury
Chronic kidney disease
Cystatin C
Data: Nov-2016
Editora: Elsevier
Citação: SOTO, 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. 1090-1099
Resumo: We 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 strategies
Peer review: yes
URI: http://hdl.handle.net/10400.21/7273
DOI: 10.1016/j.kint.2016.07.018
ISSN: 0085-2538
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