Long-term Renal Outcome In Patients After Acute Kidney Injury

Objective: To track the long-term prognosis of acute kidney injury, furtheridentify the risk factors associated with the prognosis of the AKI patients;to find thedifferences between CKD and non-CKD group in clinical features and prognosis of acutekidney injury.Methods: A retrospective analysis of450cases in2011-2012in the First Affiliated Hospitalof Fujian Medical University of AKI(AKIN meet the diagnostic criteria) which that occurredduring hospitalization and survived to hospital discharge follo-up of more than three months ormore clinical data of patients, and in accordance with the basis of whether patients with chronickidney disease will be divided into CKD and non-CKD group group group to analyze thelong-term prognosis and analysis of prognostic factors using multivariate logistic regression.results:.1. Non-CKD group had252cases to AKI1of the main,discaarge of hospital for3-12months renal function did not recover were167cases (66.3%), CKD3periodand above were83cases (32.9%),14cases progressed to ESRD patients (5.6%).2. Hypertension (P=0.014), creatinine level at discharge (P=0.002) and the age(P=0.02) are the high-risk factors of Non-CKD group failing to restore long-termrenal function,while the highest creatinine levels during hospitalization affect thefinal CKD stage.3. Non-CKD group without chronic complications of21cases of patients withepidemic hemorrhagic fever and infection caused mainly. Discharged3-12monthsdid not recover renal function in10cases, four people who did not recover toCKD3of development and more.4. When the non-CKD group,55patients discharged renal function returned tonormal, but3-12months later23patients’s renal function deteriorated again, andprogressed to ESRD were2cases. 5.14cases of non-CKD group ESRD in common:(1) Except one were associatedwith chronic complications.(2) The lowest GFR during hospitalization were lowerthan60ml/min.6. A total of198cases of CKD patients, the top three the main cause of high bloodwere pressure, diabetes, chronic glomerulonephritis, Basis of renal function inCKD3、CKD4main,3-12months after renal function showed that renal function notrecovery were122cases (61.6%),develop to ESRD were49cases (24.7%).Basis ofrenal function worse, worse long-term prognosis of renal function.7. Hypertension (P=0.014), basic CKD staging(P=0.023), basic Scr level (P<0.001),Scr level at discharge (P<0.001),the difference between the basic and discharge Scrlevel are the high-risk factors of CKD group failing to restore long-term renalfunction.8. CKD group of49cases of ESRD clinical features:(1) The basis of renal functionwere CKD3above;(2) Lowest GFR during hospitalization were20ml/min or less;(3) AKI2period and below all had chronic complications; AKI3withoutcomplications during hospitalization had the lowest GFR below15ml/min.9. Non-CKD group and CKD group:renal etiology are the main cause of both two,followed by pre-renal, Post-renal after, but CKD group had more cases whichicaused by renal etiology than non-CKD group, AKI staging no statisticallysignificant difference between each other;CKD group long-term renal prognosisworse than non-CKD group,when more progress to ESRD.Conclusion:1. The long-term prognosis of AKI without CKD is not optimistic, there is atendency to progress to chronic kidney disease,when progressed to CKD3of morethan32.9%, its risk factors including hypertension, discharge creatinine level,age.The highest creatinine levels during hospitalization affect its CKD staging.2. The risk factors of AKI long-term renal function in CKD group of poor prognosishad hypertension,basic renal function stage,Scr level at discharge, the difference Scrlevel between basic and discharge, Basis of renal function worse, worse long-term prognosis of renal function。...