New Orleans—Acute kidney injury that requires renal replacement therapy (AKI-D) is associated with increased risk of death, even after hospital discharge, as well as higher rates of cardiovascular disease. A recent study in a diverse community-based cohort examined whether renal recovery after AKI-D mitigates those risks. The study included all adult members of Kaiser Permanente Northern California who experienced AKI-D between January 2009 and September 2015. A cohort of patients with AKI-D who recovered adequate kidney function to allow for cessation of dialysis (n=1347) was compared with a cohort of AKI-D patients who remained on dialysis (n=1865). The primary outcomes of interest were all-cause death, heart failure, hospitalization, acute coronary syndrome, and acute ischemic stroke or transient ischemic attack within 1 year of initiation of renal replacement therapy.
Patients who recovered were younger, had higher baseline estimated glomerular filtration rate and less proteinuria, and were less likely to have pre-existing cardiovascular events, hypertension, or diabetes. In multivariate Cox regression, there was an independent association between recovery after AKI-D with a 30% lower risk of all-cause death. There was no statistically significant association between recovery after AKI-D and adjusted differences in health failure hospitalizations, acute coronary syndrome, or acute ischemic stroke or transient ischemic attack.
The researchers said, “Recovery after AKI-D was independently associated with lower short-term mortality. Interventions to promote early recovery of renal function after AKI-D should be evaluated.”
Source: Lee BJ, Hsu C-y, Parikh RK, et al. Renal recovery after dialysis-requiring AKI is associated with decreased short-term mortality. Abstract of a poster presented at the American Society of Nephrology 2017 Kidney Week, November 4, 2017, New Orleans, Louisiana.