Three-year outcomes after acute kidney injury: results of a prospective parallel group cohort study
Objectives Using a prospective study design, we aimed to characterise the effect of acute kidney injury (AKI) on long-term changes in renal function in a general hospital population. Participants Hospitalised patients with AKI (exposed) and hospitalised patients without AKI (non-exposed), recruit...
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| Format: | Article |
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BMJ Publishing Group
2017
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| Online Access: | https://eprints.nottingham.ac.uk/48239/ |
| _version_ | 1848797721943605248 |
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| author | Horne, Kerry L. Packington, Rebecca Monaghan, John Reilly, Timothy Selby, Nicholas M. |
| author_facet | Horne, Kerry L. Packington, Rebecca Monaghan, John Reilly, Timothy Selby, Nicholas M. |
| author_sort | Horne, Kerry L. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objectives Using a prospective study design, we aimed to characterise the effect of acute kidney injury (AKI) on long-term changes in renal function in a general hospital population.
Participants Hospitalised patients with AKI (exposed) and hospitalised patients without AKI (non-exposed), recruited at 3 months after hospital admission.
Design Prospective, matched parallel group cohort study, in which renal function and proteinuria were measured at 3 months, 1 year and 3 years.
Setting Single UK centre.
Clinical end points Clinical end points at 3 years were comparison of the following variables between exposed and non-exposed groups: renal function, prevalence of proteinuria and albuminuria and chronic kidney disease (CKD) progression/development at each time point. CKD progression was defined as a decrease in the estimated glomerular filtration rate (eGFR) of ≥25% associated with a decline in eGFR stage.
Results 300 exposed and non-exposed patients were successfully matched 1:1 for age and baseline renal function; 70% of the exposed group had AKI stage 1. During follow-up, the AKI group had lower eGFR than non-exposed patients at each time point. At 3 years, the mean eGFR was 60.7±21 mL/min/1.73 m2 in the AKI group compared with 68.4±21 mL/min/1.73 m2 in the non-exposed group, p=0.003. CKD development or progression at 3 years occurred in 30 (24.6%) of the AKI group compared with 10 (7.5%) of the non-exposed group, p<0.001. Albuminuria was more common in the AKI group, and increased with AKI severity. Factors independently associated with CKD development/progression after AKI were non-recovery at 90 days, male gender, diabetes and recurrent AKI.
Conclusions AKI is associated with deterioration in renal function to 3 years, even in an unselected population with predominantly AKI stage 1. Non-recovery from AKI is an important factor determining long-term outcome. |
| first_indexed | 2025-11-14T20:08:23Z |
| format | Article |
| id | nottingham-48239 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:08:23Z |
| publishDate | 2017 |
| publisher | BMJ Publishing Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-482392024-08-15T15:21:39Z https://eprints.nottingham.ac.uk/48239/ Three-year outcomes after acute kidney injury: results of a prospective parallel group cohort study Horne, Kerry L. Packington, Rebecca Monaghan, John Reilly, Timothy Selby, Nicholas M. Objectives Using a prospective study design, we aimed to characterise the effect of acute kidney injury (AKI) on long-term changes in renal function in a general hospital population. Participants Hospitalised patients with AKI (exposed) and hospitalised patients without AKI (non-exposed), recruited at 3 months after hospital admission. Design Prospective, matched parallel group cohort study, in which renal function and proteinuria were measured at 3 months, 1 year and 3 years. Setting Single UK centre. Clinical end points Clinical end points at 3 years were comparison of the following variables between exposed and non-exposed groups: renal function, prevalence of proteinuria and albuminuria and chronic kidney disease (CKD) progression/development at each time point. CKD progression was defined as a decrease in the estimated glomerular filtration rate (eGFR) of ≥25% associated with a decline in eGFR stage. Results 300 exposed and non-exposed patients were successfully matched 1:1 for age and baseline renal function; 70% of the exposed group had AKI stage 1. During follow-up, the AKI group had lower eGFR than non-exposed patients at each time point. At 3 years, the mean eGFR was 60.7±21 mL/min/1.73 m2 in the AKI group compared with 68.4±21 mL/min/1.73 m2 in the non-exposed group, p=0.003. CKD development or progression at 3 years occurred in 30 (24.6%) of the AKI group compared with 10 (7.5%) of the non-exposed group, p<0.001. Albuminuria was more common in the AKI group, and increased with AKI severity. Factors independently associated with CKD development/progression after AKI were non-recovery at 90 days, male gender, diabetes and recurrent AKI. Conclusions AKI is associated with deterioration in renal function to 3 years, even in an unselected population with predominantly AKI stage 1. Non-recovery from AKI is an important factor determining long-term outcome. BMJ Publishing Group 2017-03-01 Article PeerReviewed Horne, Kerry L., Packington, Rebecca, Monaghan, John, Reilly, Timothy and Selby, Nicholas M. (2017) Three-year outcomes after acute kidney injury: results of a prospective parallel group cohort study. BMJ Open, 7 (3). e015316/1-e015316/7. ISSN 2044-6055 http://bmjopen.bmj.com/content/7/3/e015316 doi:10.1136/bmjopen-2016-015316 doi:10.1136/bmjopen-2016-015316 |
| spellingShingle | Horne, Kerry L. Packington, Rebecca Monaghan, John Reilly, Timothy Selby, Nicholas M. Three-year outcomes after acute kidney injury: results of a prospective parallel group cohort study |
| title | Three-year outcomes after acute kidney injury: results of a prospective parallel group cohort study |
| title_full | Three-year outcomes after acute kidney injury: results of a prospective parallel group cohort study |
| title_fullStr | Three-year outcomes after acute kidney injury: results of a prospective parallel group cohort study |
| title_full_unstemmed | Three-year outcomes after acute kidney injury: results of a prospective parallel group cohort study |
| title_short | Three-year outcomes after acute kidney injury: results of a prospective parallel group cohort study |
| title_sort | three-year outcomes after acute kidney injury: results of a prospective parallel group cohort study |
| url | https://eprints.nottingham.ac.uk/48239/ https://eprints.nottingham.ac.uk/48239/ https://eprints.nottingham.ac.uk/48239/ |