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Characteristics and outcomes in community-acquired versus hospital-acquired acute kidney injury.
Nephrology (Carlton) 2013; 18(3):183-7N

Abstract

AIM

Relatively little is known about the prevalence of acute kidney injury developing outside a hospital setting (CA-AKI) or the impact of CA-AKI on short-term or long-term clinical outcomes. The objective of this study was to compare the prevalence, causes, severity and outcomes of patients with CA-AKI and hospital-acquired (HA)-AKI.

METHODS

A retrospective cohort study of patients with AKI identified by ICD-9 code at a single VA (Veterans Affairs) hospital from September 1999 to May 2007 was performed. AKI was verified by applying the RIFLE criteria, and patients were categorized as CA-AKI if RIFLE criteria were met at admission. Demographic, clinical, and outcome variables were extracted by chart review.

RESULTS

Four hundred twenty-two patients met inclusion criteria, of which 335 (79.4%) developed CA-AKI. Patients with CA-AKI were more likely to have volume depletion as the aetiology, had fewer chronic illnesses and hospital complications, had a shorter length of stay, and had a reduced mortality, compared with HA-AKI. Distribution among the three RIFLE classes did not differ between groups, and recovery of renal function was incomplete in both groups.

CONCLUSION

We conclude that CA-AKI is a common cause of AKI that is as severe as that seen in HA-AKI. CA-AKI has a significant impact on length of hospital stay, mortality, and the development and/or progression of chronic kidney disease. Strategies to limit the risk of CA-AKI are likely to have a significant impact on healthcare costs and patient care.

Authors+Show Affiliations

Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23336108

Citation

Schissler, Michael M., et al. "Characteristics and Outcomes in Community-acquired Versus Hospital-acquired Acute Kidney Injury." Nephrology (Carlton, Vic.), vol. 18, no. 3, 2013, pp. 183-7.
Schissler MM, Zaidi S, Kumar H, et al. Characteristics and outcomes in community-acquired versus hospital-acquired acute kidney injury. Nephrology (Carlton). 2013;18(3):183-7.
Schissler, M. M., Zaidi, S., Kumar, H., Deo, D., Brier, M. E., & McLeish, K. R. (2013). Characteristics and outcomes in community-acquired versus hospital-acquired acute kidney injury. Nephrology (Carlton, Vic.), 18(3), pp. 183-7. doi:10.1111/nep.12036.
Schissler MM, et al. Characteristics and Outcomes in Community-acquired Versus Hospital-acquired Acute Kidney Injury. Nephrology (Carlton). 2013;18(3):183-7. PubMed PMID: 23336108.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics and outcomes in community-acquired versus hospital-acquired acute kidney injury. AU - Schissler,Michael M, AU - Zaidi,Syed, AU - Kumar,Haresh, AU - Deo,Datinder, AU - Brier,Michael E, AU - McLeish,Kenneth R, PY - 2013/01/06/accepted PY - 2013/1/23/entrez PY - 2013/1/23/pubmed PY - 2013/8/13/medline SP - 183 EP - 7 JF - Nephrology (Carlton, Vic.) JO - Nephrology (Carlton) VL - 18 IS - 3 N2 - AIM: Relatively little is known about the prevalence of acute kidney injury developing outside a hospital setting (CA-AKI) or the impact of CA-AKI on short-term or long-term clinical outcomes. The objective of this study was to compare the prevalence, causes, severity and outcomes of patients with CA-AKI and hospital-acquired (HA)-AKI. METHODS: A retrospective cohort study of patients with AKI identified by ICD-9 code at a single VA (Veterans Affairs) hospital from September 1999 to May 2007 was performed. AKI was verified by applying the RIFLE criteria, and patients were categorized as CA-AKI if RIFLE criteria were met at admission. Demographic, clinical, and outcome variables were extracted by chart review. RESULTS: Four hundred twenty-two patients met inclusion criteria, of which 335 (79.4%) developed CA-AKI. Patients with CA-AKI were more likely to have volume depletion as the aetiology, had fewer chronic illnesses and hospital complications, had a shorter length of stay, and had a reduced mortality, compared with HA-AKI. Distribution among the three RIFLE classes did not differ between groups, and recovery of renal function was incomplete in both groups. CONCLUSION: We conclude that CA-AKI is a common cause of AKI that is as severe as that seen in HA-AKI. CA-AKI has a significant impact on length of hospital stay, mortality, and the development and/or progression of chronic kidney disease. Strategies to limit the risk of CA-AKI are likely to have a significant impact on healthcare costs and patient care. SN - 1440-1797 UR - https://www.unboundmedicine.com/medline/citation/23336108/Characteristics_and_outcomes_in_community_acquired_versus_hospital_acquired_acute_kidney_injury_ L2 - https://doi.org/10.1111/nep.12036 DB - PRIME DP - Unbound Medicine ER -