Dataset Information

Pyogenic Liver Abscess is Associated With Increased Risk of Acute Kidney Injury: A Nationwide Population-Based Cohort Study.

ABSTRACT: The aim of this large population-based cohort study was to determine whether pyogenic liver abscess (PLA) is associated with the risk of acute kidney injury (AKI).A total of 31,815 patients aged 20 years or older diagnosed with PLA for the first time during hospitalization between 2000 and 2011 were included in a PLA cohort, and 127,620 age- and sex-matched patients without PLA were included in a non-PLA cohort. The incidence and the risk of the first attack of AKI at the end of 2011 were measured. Cox proportional hazard regression models were used to analyze the risk of AKI.In mean follow-up periods of 4.36 and 4.94 years for the PLA and non-PLA cohorts, respectively, the overall incidence of AKI was 1.51-fold greater in the PLA cohort than in the non-PLA cohort (9.25 vs 6.11 events per 1000 person-years; 95% confidence intervals [CIs]?=?1.42-1.61). After we controlled for potential confounding factors, the adjusted hazard ratio (aHR) of AKI was 1.36 (95% CIs?=?1.27-1.46) for the PLA cohort compared with the non-PLA cohort. Moreover, among patients without comorbidities, the risk of AKI remained higher in the PLA cohort compared with the non-PLA cohort (aHR: 1.91, 95% CIs?=?1.59-2.29).This study suggests that PLA associates with an increased risk of AKI. Clinicians should be aware of the potential risk of AKI after diagnosis of PLA.

SUBMITTER: Sung CC

PROVIDER: S-EPMC4998258 | biostudies-other | 2016 Jan

REPOSITORIES: biostudies-other

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Pyogenic Liver Abscess is Associated With Increased Risk of Acute Kidney Injury: A Nationwide Population-Based Cohort Study.

Sung Chih-Chien CC Lin Chin-Sheng CS Lin Shih-Hua SH Lin Cheng-Li CL Jhang Kai-Ming KM Kao Chia-Hung CH

Medicine 20160101 3

The aim of this large population-based cohort study was to determine whether pyogenic liver abscess (PLA) is associated with the risk of acute kidney injury (AKI).A total of 31,815 patients aged 20 years or older diagnosed with PLA for the first time during hospitalization between 2000 and 2011 were included in a PLA cohort, and 127,620 age- and sex-matched patients without PLA were included in a non-PLA cohort. The incidence and the risk of the first attack of AKI at the end of 2011 were measur ...[more]

PMID: 26817884

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Project description:Rationale & objectiveAcute kidney injury (AKI) has numerous sequelae. Repeated episodes of AKI may be an important determinant of adverse outcomes, including chronic kidney disease and death. In a population-based cohort study, we sought to determine the incidence of and predictors for recurrent AKI.Study designRetrospective cohort study.Setting & participants38,659 hospitalized members of Kaiser Permanente Northern California who experienced an episode of AKI from 2006 to 2013.PredictorsDemographic, clinical, and laboratory data, including baseline kidney function, proteinuria, hemoglobin level, comorbid conditions, and severity of AKI.OutcomesIncidence and predictors of recurrent AKI.Analytical approachMultivariable Cox proportional hazard regression.Results11,048 (28.6%) experienced a second hospitalization complicated by AKI during follow-up (11.2 episodes/100 person-years), with the second episode of AKI occurring a median of 0.6 (interquartile range, 0.2-1.9) years after the first hospitalization. In multivariable analyses, older age, black race, and Hispanic ethnicity were associated with recurrent AKI, along with lower estimated glomerular filtration rate, proteinuria, and anemia. Concomitant conditions, including heart failure, acute coronary syndrome, diabetes, and chronic liver disease, were also multivariable predictors of recurrent AKI. Those who had higher acuity of illness during the initial hospitalization were more likely to have recurrent AKI, but greater AKI severity of the index episode was not independently associated with increased risk for recurrent AKI. In multivariable analysis of matched patients, recurrent AKI was associated with an increased rate of death (HR, 1.66; 95% CI, 1.57-1.77).LimitationsAnalyses were based on clinically available data, rather than protocol-driven timed measurements of kidney function.ConclusionsRecurrent AKI is a common occurrence after a hospitalization complicated by AKI. Based on routinely available patient characteristics, our findings could facilitate identification of the subgroup of patients with AKI who may benefit from more intensive follow-up to potentially avoid recurrent AKI episodes.

Dataset Information

Pyogenic Liver Abscess is Associated With Increased Risk of Acute Kidney Injury: A Nationwide Population-Based Cohort Study.

Publications

Pyogenic Liver Abscess is Associated With Increased Risk of Acute Kidney Injury: A Nationwide Population-Based Cohort Study.

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