Referral patterns and outcomes in noncritically ill patients with hospital-acquired acute kidney injury.

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State: Public
Version: author
Serval ID
serval:BIB_38F3632725F0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Referral patterns and outcomes in noncritically ill patients with hospital-acquired acute kidney injury.
Journal
Clinical Journal of the American Society of Nephrology
Author(s)
Meier P., Meier Bonfils R., Vogt B., Burnand B., Burnier M.
ISSN
1555-905X (Electronic)
ISSN-L
1555-9041
Publication state
Published
Issued date
2011
Peer-reviewed
Oui
Volume
6
Number
9
Pages
2215-2225
Language
english
Abstract
Background and objectives Despite modern treatment, the case fatality rate of hospital-acquired acute kidney injury (HA-AKI) is still high. We retrospectively described the prevalence and the outcome of HA-AKI without nephrology referral (nrHA-AKI) and late referred HA-AKI patients to nephrologists (lrHA-AKI) compared with early referral patients (erHA-AKI) with respect to renal function recovery, renal replacement therapy (RRT) requirement, and in-hospital mortality of HA-AKI. Design, setting, participants, & measurements Noncritically ill patients admitted to the tertiary care academic center of Lausanne, Switzerland, between 2004 and 2008 in the medical and surgical services were included. Acute kidney injury was defined using the Acute Kidney Injury Network (AKIN) classification. Results During 5 years, 4296 patients (4.12% of admissions) experienced 4727 episodes of HA-AKI during their hospital stay. The mean ± SD age of the patients was 61 ± 15 years with a 55% male predominance. There were 958 patients with nrHA-AKI (22.3%) and 2504 patients with lrHA-AKI (58.3%). RRT was required in 31% of the patients with lrHA-AKI compared with 24% of the patients with erHA-AKI. In the multiple risk factor analysis, compared with erHA-AKI, nrHA-AKI and lrHA-AKI were significantly associated with worse renal outcome and higher in-hospital mortality. Conclusions These data suggest that HA-AKI is frequent and the patients with nrHA-AKI or lrHA-AKI are at increased risk for in-hospital morbidity and mortality.
Keywords
Acute Kidney Injury/mortality, Acute Kidney Injury/therapy, Aged, Creatinine/blood, Female, Hospital Mortality, Hospitalization, Humans, Length of Stay, Male, Middle Aged, Referral and Consultation, Renal Replacement Therapy, Retrospective Studies
Pubmed
Web of science
Open Access
Yes
Create date
08/08/2011 10:07
Last modification date
20/08/2019 13:28
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