Mild Stage 1 post-operative acute kidney injury: association with chronic kidney disease and long-term survival

• Published in: Clinical Kidney Journal 2021-01, Vol.14 (1), p.237-244
• Main Authors: Long, Thorir Einarsson, Helgason, Dadi, Helgadottir, Solveig, Sigurdsson, Gisli Heimir, Palsson, Runolfur, Sigurdsson, Martin Ingi, Indridason, Olafur Skuli
• Format: Article
• Language: English
• Subjects: acute kidney injury; chronic kidney disease; Chronic kidney failure; Comparative analysis; KDIGO criteria; Medical research; Medicine, Experimental; Original; serum creatinine; survival
• ISSN: 2048-8505; 2048-8513; 2048-8513
• DOI: 10.1093/ckj/sfz197

Abstract Background Mild cases of acute kidney injury (AKI) are identified by a small rise in serum creatinine (SCr) according to the KDIGO AKI definition. The aim of this study was to examine the long-term outcomes of individuals with mild AKI. Methods. This was a retrospective cohort study of all adult patients who underwent abdominal, cardiothoracic, vascular or orthopaedic surgery at Landspitali–The National University Hospital of Iceland in 1998–2015. Incident chronic kidney disease (CKD), progression of pre-existing CKD and long-term survival were compared between patients with mild Stage 1 AKI (defined as a rise in SCr of ≥26.5 μmol/L within 48 h post-operatively without reaching 1.5× baseline SCr within 7 days), and a propensity score-matched control group without AKI stratified by the presence of CKD. Results Pre- and post-operative SCr values were available for 47 333 (42%) surgeries. Of those, 1161 (2.4%) had mild Stage 1 AKI and 2355 (5%) more severe forms of AKI. Mild Stage 1 AKI was associated with both incident CKD and progression of pre-existing CKD (P