Dr Candice Khor1, Dr Maria Maawad1, Dr Jonathan Erlich1, Prof Zoltan Endre1
1Prince of Wales Hospital, Randwick, Australia
Aim:
To describe the characteristics and evaluate outcomes of inpatients consulted for acute kidney injury (AKI).
Background:
AKI occurs in 7-18% of hospitalised patients and associated with significant morbidity and mortality. Follow-up rates are poor despite studies showing early nephrology review improves overall survival.
Methods:
An audit was undertaken on inpatients consulted for AKI in 2021 at Prince of Wales Hospital (POWH). Demographic, clinical and laboratory data were retrieved from electronic medical records.
Results:
Out of approximately 1020 patients with AKI detected yearly by the POWH AKI electronic alert, 104 were consulted by nephrology in 2021. 30 had stage 1 AKI, 19 had stage 2 AKI and 54 had stage 3 AKI. 14 required dialysis and 35 required ICU admission. 65 patients (63%) had AKD and 20 (20%) developed incident or progressive chronic kidney disease (CKD). 29 (28%) had recurrent AKI within 3 months and 25 (24%) patients died. 36 (35%) patients had renal follow-up at POWH, 15 (14%) lived outside the POWH catchment area, 21 (20%) did not attend nephrology follow-up, 21 (20%) had poor prognosis or died in hospital and 11 (11%) had no renal follow-up organised. On univariate analysis, AKD was associated with younger patients, no history of hypertension and the absence of CKD, the latter remaining significant on multivariate analysis (p=0.015). Progressive CKD was associated with higher baseline serum creatinine (p=0.0007) and longer length of stay (p=0.0140) on multivariate analysis.
Conclusion:
In a cohort of patients consulted for AKI, 63% developed AKD, 28% had recurrent AKI and 20% developed incident or progressive CKD. AKD associated with younger age and the absence of CKD and hypertension, can affect all patients with AKI.
Biography:
Dr Candice Khor is currently the renal fellow at the Prince of Wales Hospital in Sydney, Australia. She recently completed her renal advanced training. Her clinical and research interests include acute kidney injury, glomerulonephritis and renal transplant.