SHORT- & LONG-TERM MORTALITY AFTER AN AKI IN NON-CRITICAL SETTING
Dr Maria Maawad1, Dr Camila Eleuterio Rodrigues, Dr Jonathan Erlich, Prof Zoltan Endre
1Prince Of Wales Hospital, , Australia
Aim: To describe short- and long-term mortality for inpatients consulted for acute kidney injury (AKI) outside intensive care Unit (ICU).
Background: Acute kidney injury (AKI) is characterized by a high mortality rate. While most patients with AKI are admitted in general medical units (GMU), current available data largely reflect studies for patients admitted in ICU.
Methods: Inpatients consulted from GMU for AKI between June 2021 and August 2023 at Prince of Wales Hospital were included if they had a baseline preadmission creatinine within the previous 12 months. Epidemiological and clinical data were collected.
Results: Out of 149 consulted patients with AKI, 59 patients had stage 1 AKI, 48 stage 2 and 42 stage 3 (KDIGO). Median age was 74, male 57.04%, CKD in 91 patients (61%). Mortality was reported in 56 patients (37.58%): mean age was 76.6 (SD 10.98), 64.3% male, 75% CKD, 69.6% HTN, and 50% DM. Using the LIION criteria, the main causes of AKI were Low perfusion (hypovolaemia,64.2%; cardiogenic, 28.6%), and Inflammatory (sepsis, 46%). 22 patients died within 90 days, 24 between 91 days and 1 year, and 10 between 1 and 2 years. 3 patients requiring RRT died within 90 days. The presence of pre-existing CKD and requiring RRT during the admission increased the risk of mortality. In a logistic regression model, the duration of AKI was an independent predictor of mortality even after correction for age and CKD.
Conclusion: This study emphasizes the importance of monitoring and managing AKI in non-critical settings. This is the first study assessing AKI outcomes in non-critical patients. Early detection and appropriate interventions can significantly impact patient’s outcomes.
Biography:
Graduated in Medicine at University of São Paulo, Brazil, in 2005. Specialised in Nephrology at Hospital das Clínicas, University of São Paulo School of Medicine. PhD in Nephrology obtained in 2015. Currently, Post-Doctorate Fellowship at Prince of Wales Hospital, University of New South Wales, Sydney, Australia.