Factors Associated with Reduction Renal Function in Post Acute Kidney Injury Patients in Ratchaburi Hospital
Keywords:
acute kidney injury, glomerular filtration rate, chronic kidney disease, incident CKD, progress CKDAbstract
Background: Acute kidney injury (AKI) was a common problem of the hospitalized patients and associated with significant morbidities, mortalities and declined renal function in long term follow-ups, as well as subsequent risk for chronic kidney disease development and progression.
Objective: To determine factors associated with reduction renal function in post AKI hospitalized patients, rate of incidence, mortality, renal replacement therapy, and compared renal function (estimated glomerular filtration rate; eGFR) within 2 years with baseline renal function before admissions.
Methods: The data were retrospectively reviewed from prospectively collected database of hospitalized patients diagnosed as AKI by ICD 10 coding, between 1 June, 2014 - 1 May, 2015.
Demographic data were analyzed by using frequency, percent, mean and standard deviation. Compare of eGFR between baseline with 1 and 2 years post AKI by one-way ANOVA, and analysis of factors associated reduction eGFR< 25% and > 25% at 2 years compared with baseline renal function by binary logistic regression were done. Program SPSS for Windows version 13.0 was used for analysis.
Results: 1,342 AKI- patients were analyzed for incidence rate of AKI was 2.9%, mortality rate was 30% and 7.5% received renal replacement therapy. 103 AKI patients included from the criteria were analyzed, found renal function (eGFR) reduction 10 and 11.6 ml/min/1.73m2 in 1 year and 2 years follow-ups, respectively. Incident CKD was 6.3%, progression CKD was 17.9%. Diabetes (OR= 2.4, 95%CI 1.1-5.6, p= 0.035) and chronic kidney disease (OR= 3.4, 95%CI 1.5-8.0, p=0.005) were risk factors for reduction eGFR> 25% at 2 years follow -ups compared with baseline renal function. And the recovery renal function in hospital could 95% protect for declined eGFR> 25% (OR=0.045, 95%CI 0.005-0.376, p=0.004).
Conclusion: AKI was a major risk factor for subsequent reduction renal function in long term follow-ups, especially in patients with diabetes and chronic kidney disease those should be followed up and proper management for retardation renal progression.
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