Dataset Information

Kidney function before and after acute kidney injury: a nationwide population-based cohort study.

ABSTRACT:

Background

Acute kidney injury (AKI) is a common and serious condition defined by a rapid decline in kidney function. Data on changes in long-term kidney function following AKI are sparse and conflicting. Therefore, we examined the changes in estimated glomerular filtration rate (eGFR) from before to after AKI in a nationwide population-based setting.

Methods

Using Danish laboratory databases, we identified individuals with first-time AKI defined by an acute increase in plasma creatinine (pCr) during 2010 to 2017. Individuals with three or more outpatient pCr measurements before and after AKI were included and cohorts were stratified by baseline eGFR (≥/<60 mL/min/1.73 m²). Linear regression models were used to estimate and compare individual eGFR slopes and eGFR levels before and after AKI.

Results

Among individuals with a baseline eGFR ≥60 mL/min/1.73 m² (n = 64 805), first-time AKI was associated with a median difference in eGFR level of -5.6 mL/min/1.73 m² [interquartile range (IQR) -16.1 to 1.8] and a median difference in eGFR slope of -0.4 mL/min/1.73 m²/year (IQR -5.5 to 4.4). Correspondingly, among individuals with a baseline eGFR <60 mL/min/1.73 m² (n = 33 267), first-time AKI was associated with a median difference in eGFR level of -2.2 mL/min/1.73 m² (IQR -9.2 to 4.3) and a median difference in eGFR slope of 1.5 mL/min/1.73 m²/year (IQR -2.9 to 6.5).

Conclusion

Among individuals with first-time AKI surviving to have repeated outpatient pCr measurements, AKI was associated with changes in eGFR level and eGFR slope for which the magnitude and direction depended on baseline eGFR.

SUBMITTER: Jensen SK

PROVIDER: S-EPMC9972836 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Kidney function before and after acute kidney injury: a nationwide population-based cohort study.

Jensen Simon Kok SK Heide-Jørgensen Uffe U Vestergaard Søren Viborg SV Gammelager Henrik H Birn Henrik H Nitsch Dorothea D Christiansen Christian Fynbo CF

Clinical kidney journal 20221118 3

<h4>Background</h4>Acute kidney injury (AKI) is a common and serious condition defined by a rapid decline in kidney function. Data on changes in long-term kidney function following AKI are sparse and conflicting. Therefore, we examined the changes in estimated glomerular filtration rate (eGFR) from before to after AKI in a nationwide population-based setting.<h4>Methods</h4>Using Danish laboratory databases, we identified individuals with first-time AKI defined by an acute increase in plasma cre ...[more]

PMID: 36865015

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Project description:BackgroundPatients undergoing treatment for cancer are at increased risk of acute kidney injury (AKI). There are few data on AKI incidence and risk factors in the current era of cancer treatment.MethodsWe conducted a population-based study of all patients initiating systemic therapy (chemotherapy or targeted agents) for a new cancer diagnosis in Ontario, Canada (2007-2014). The primary outcome was hospitalization with AKI or acute dialysis. We estimated the cumulative incidence of AKI and fitted Fine and Gray models, adjusting for demographics, cancer characteristics, comorbidities, and coprescriptions. We modeled exposure to systemic therapy (the 90-day period following treatments) as a time-varying covariate. We also assessed temporal trends in annual AKI incidence.ResultsWe identified 163 071 patients initiating systemic therapy of whom 10 880 experienced AKI. The rate of AKI was 27 per 1000 person-years, with overall cumulative incidence of 9.3% (95% CI = 9.1% to 9.6%). Malignancies with the highest 5-year AKI incidence were myeloma (26.0%, 95% CI = 24.4% to 27.7%), bladder (19.0%, 95% CI = 17.6% to 20.5%), and leukemia (15.4%, 95% CI = 14.3% to 16.5%). Advanced cancer stage, chronic kidney disease, and diabetes were associated with increased risk of AKI (adjusted hazard ratios [aHR] = 1.41, 95% CI = 1.28 to 1.54; 1.80, 95% CI = 1.67 to 1.93; and 1.43, 95% CI = 1.37 to 1.50, respectively). In patients aged 66 years or older with universal drug benefits, diuretic, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker coprescription was associated with higher AKI risk (aHR = 1.20, 95% CI = 1.14 to 1.28; 1.30, 95% CI = 1.23 to 1.38). AKI risk was further accentuated during the 90-day period following systemic therapy (aHR = 2.34, 95% CI = 2.24 to 2.45). The annual incidence of AKI increased from 18 to 52 per 1000 person-years between 2007 and 2014.ConclusionCancer-related AKI is common and associated with advanced stage, chronic kidney disease, diabetes, and concomitant receipt of diuretics or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Risk is heightened in the 90 days after systemic therapy. Preventive strategies are needed to address the increasing burden of AKI in this population.

Dataset Information

Kidney function before and after acute kidney injury: a nationwide population-based cohort study.

Background

Methods

Results

Conclusion

Publications

Kidney function before and after acute kidney injury: a nationwide population-based cohort study.

Similar Datasets

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