Abstract
BackgroundDialysis-requiring acute kidney injury (AKI) is associated with substantial mortality and risk of end-stage renal disease (ESRD). Despite considerable growth in incidence of severe AKI, information pertaining to trends in outcomes remains limited. We evaluated time trends in one year risks of ESRD and death in patients with dialysis-requiring AKI over an eight year period in Denmark.MethodsIn a retrospective nationwide study based on national registers, all adults requiring acute renal replacement therapy between 2005 and 2012 were identified. Patients with preceding ESRD were excluded. Through individual-level cross-referencing of administrative registries, information pertaining to comorbidity, preceding surgical interventions, and concurrent other organ failure and sepsis was ascertained. Comparisons of period-specific one year odds ratios for ESRD and death were calculated in a multiple logistic regression model.ResultsA total of 13,819 patients with dialysis-requiring AKI were included in the study. Within one year, 1,017 (7.4%) patients were registered with ESRD, and 7,908 (57.2%) patients died. The one-year rate of ESRD decreased from 9.0% between 2005 and 2006 to 6.1% between 2011 and 2012. Simultaneously, the one-year mortality rate decreased from 58.2% between 2005 and 2006 to 57.5% between 2011 and 2012. Consequently, the adjusted odds ratios for the period 2011–2012 (with the period 2005–2006 as reference) were 0.75 (0.60–0.95, p = 0.015) and 0.87 (95% CI 0.78–0.97, p = 0.010) for ESRD and death, respectively.ConclusionsIn a nationwide retrospective study on time trends in one year outcomes following dialysis-requiring AKI, risk of all-cause mortality and ESRD decreased over a period of 8 years.
Highlights
Acute kidney injury (AKI) continues to be a severe disease associated with poor prognosis [1, 2]
A total of 13,819 patients with dialysis-requiring acute kidney injury (AKI) were included in the study
1,017 (7.4%) patients were registered with end-stage renal disease (ESRD), and 7,908 (57.2%) patients died
Summary
Acute kidney injury (AKI) continues to be a severe disease associated with poor prognosis [1, 2]. AKI is associated with substantially increased propensity for chronic kidney disease (CKD) including end-stage renal disease (ESRD) [8,9,10,11]. Crude incidence rates of dialysis-requiring AKI have increased substantially throughout the last two decades [12, 13]; Danish incidence rates have remained stable at approximately 350 per million since 2006 [14], and information pertaining to temporal change in outcomes following AKI continues to be limited [15, 16]. Dialysis-requiring acute kidney injury (AKI) is associated with substantial mortality and risk of end-stage renal disease (ESRD).
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