P0577CLINICAL CHARACTERISTICS AND IN-HOSPITAL OUTCOME FOR 1798 CONSECUTIVE PATIENTS WITH ACUTE KIDNEY INJURY

Abstract

Abstract Background and Aims Acute kidney injury (AKI) is a common condition occurring in about 15% of all hospitalized patients. AKI have different pathophysiological etiologies; prerenal, renal or postrenal. Patients who recover from AKI have a higher long-term risk of end-stage kidney disease and death. However, most AKI studies include critically ill patients treated at intensive care units; less is known about general AKI patients treated at the nephrology ward. The aim of this large single center study was to report differences in laboratory findings and short-term hospital outcomes in relation to cause of AKI in consecutive patients admitted to a nephrology department. Method All patients diagnosed with AKI between 2009 and 2018 and admitted to the nephrology department at Danderyd University Hospital, Stockholm, Sweden, were included. Relevant laboratory and physiological measures were registered, including length of stay, procedures, etiology and level of AKI. AKI was defined as a first s-creatinine (sCr) >130 µmol/L (1.47 mg/dL) at admission, or an increase in sCr by 30% from previous stable out-patient value. These criteria were set at the beginning of the study based on clinical knowledge and clinical practice at the time. Patients on dialysis treatment were excluded. Patients were followed until either discharge or death, whichever came first. Results In 1798 patients with AKI, the majority (n=851) had combined type, followed by prerenal (n=668), renal (n=175), and postrenal (n=104) etiology. Patients with renal AKI were younger, had longer duration of stay, and had higher bicarbonate levels on admission (Table 1). The most common cause of renal AKI was interstitial nephritis. Patients with prerenal AKI had lower S-Cr, blood pressure and higher Hb upon admission. 58% of the patients recovered with an at least 30% decrease in sCr from baseline during their stay. Most of these were patients with prerenal AKI followed by combined AKI. There was no statistically significant difference in mortality between the four etiologies of AKI. Conclusion This study provides data from a large, contemporary AKI patient cohort under nephrology care. Both patient characteristics and short-term outcomes differ substantially in patients of variable AKI etiology. These findings have important implications for prognostic evaluation upon admission and further resource planning.