Outcomes associated with acute kidney disease: A systematic review and meta-analysisResearch in context
Summary: Background: Acute kidney disease (AKD) defines the period after kidney damage and it is a critical period of both repair and fibrotic pathways. However, the outcomes of patients with AKD have not been well-defined. Methods: In this meta-analysis, PubMed, Embase, Cochrane and China National...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-01-01
|
| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022004898 |
| _version_ | 1828116085072723968 |
|---|---|
| author | Ching-Chun Su Jui-Yi Chen Sheng-Yin Chen Chih-Chung Shiao Javier A. Neyra Ryo Matsuura Eisei Noiri Emily See Yih-Ting Chen Cheng-Kai Hsu Heng-Chih Pan Chih-Hsiang Chang Mitchell H. Rosner Vin-Cent Wu |
| author_facet | Ching-Chun Su Jui-Yi Chen Sheng-Yin Chen Chih-Chung Shiao Javier A. Neyra Ryo Matsuura Eisei Noiri Emily See Yih-Ting Chen Cheng-Kai Hsu Heng-Chih Pan Chih-Hsiang Chang Mitchell H. Rosner Vin-Cent Wu |
| author_sort | Ching-Chun Su |
| collection | DOAJ |
| description | Summary: Background: Acute kidney disease (AKD) defines the period after kidney damage and it is a critical period of both repair and fibrotic pathways. However, the outcomes of patients with AKD have not been well-defined. Methods: In this meta-analysis, PubMed, Embase, Cochrane and China National Knowledge Infrastructure were searched on July 31,2022. We excluded studies including patients undergoing kidney replacement therapy at enrollment. The data was used to conduct a random-effects model for pool outcomes between patients with AKD and non-AKD (NKD). This study is registered with PROSPERO, CRD 42021271773. Findings: The search generated 739 studies of which 21 studies were included involving 1,114,012 patients. The incidence rate of community-acquired AKD was 4.60%, 2.11% in hospital-acquired AKD without a prior AKI episode, and 26.11% in hospital-acquired AKD with a prior AKI episode. The all-cause mortality rate was higher in the AKD group (26.54%) than in the NKD group (7.78%) (odds ratio [OR]: 3.62, 95% confidence interval [CI]: 2.64 to 4.95, p < 0.001, I2 = 99.11%). The rate of progression to end-stage kidney disease (ESKD) was higher in the AKD group (1.3%) than in the NKD group (0.14%) (OR: 6.58, p < 0.001, I2 = 94.95%). The incident rate of CKD and progressive CKD was higher in the AKD group (37.2%) than in the NKD group (7.45%) (OR:4.22, p < 0.001, I2 = 96.67%). Compared to the NKD group, patients with AKD without prior AKI had a higher mortality rate (OR: 3.00, p < 0.001, I2 = 99.31%) and new-onset ESKD (OR:4.96, 95% CI, p = 0.002, I2 = 97.37%). Interpretation: AKD is common in community and hospitalized patients who suffer from AKI and also occurs in patients without prior AKI. The patients with AKD, also in those without prior AKI had a higher risk of mortality, and new-onset ESKD than the NKD group. Funding: This study was supported by Ministry of Science and Technology (MOST) of the Republic of China (Taiwan) [grant number, MOST 107-2314-B-002-026-MY3, 108-2314-B-002-058, 110-2314-B-002-241, 110-2314-B-002-239], National Science and Technology Council (NSTC) [grant number, NSTC 109-2314-B-002-174-MY3, 110-2314-B-002-124-MY3, 111-2314-B-002-046, 111-2314-B-002-058], National Health Research Institutes [PH-102-SP-09], National Taiwan University Hospital [109-S4634, PC-1246, PC-1309, VN109-09, UN109-041, UN110-030, 111-FTN0011] Grant MOHW110-TDU-B-212-124005, Mrs. Hsiu-Chin Lee Kidney Research Fund and Chi-mei medical center CMFHR11136. JAN is supported, in part, by grants from the National Institute of Health, NIDDK (R01 DK128208 and P30 DK079337) and NHLBI (R01 HL148448-01). |
| first_indexed | 2024-04-11T12:51:34Z |
| format | Article |
| id | doaj.art-3830c26d7b7040cbb8d641dc1066d752 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-11T12:51:34Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-3830c26d7b7040cbb8d641dc1066d7522022-12-22T04:23:11ZengElsevierEClinicalMedicine2589-53702023-01-0155101760Outcomes associated with acute kidney disease: A systematic review and meta-analysisResearch in contextChing-Chun Su0Jui-Yi Chen1Sheng-Yin Chen2Chih-Chung Shiao3Javier A. Neyra4Ryo Matsuura5Eisei Noiri6Emily See7Yih-Ting Chen8Cheng-Kai Hsu9Heng-Chih Pan10Chih-Hsiang Chang11Mitchell H. Rosner12Vin-Cent Wu13Division of Nephrology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, TaiwanDivision of Nephrology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan; Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, TaiwanHarvard T.H. Chan School of Public Health, Boston, MA, USADivision of Nephrology, Department of Internal Medicine, Camillian Saint Mary's Hospital Luodong; and Saint Mary's Junior College of Medicine, Nursing and Management, Yilan, TaiwanDepartment of Internal Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL, USADepartment of Nephrology and Endocrinology, The University of Tokyo Hospital, Tokyo, JapanNational Center Biobank Network, National Center for Global Health and Medicine, Shinjuku, JapanDepartment of Nephrology, Royal Melbourne Hospital, Melbourne, Australia; Department of Intensive Care, Royal Melbourne Hospital, Melbourne, AustraliaDivision of Nephrology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, TaiwanDivision of Nephrology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, TaiwanDivision of Nephrology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, TaiwanDivision of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan City, TaiwanDepartment of Medicine, University of Virginia Health System Charlottesville, VA, 22908, USADepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District Taipei 100, Taiwan.Summary: Background: Acute kidney disease (AKD) defines the period after kidney damage and it is a critical period of both repair and fibrotic pathways. However, the outcomes of patients with AKD have not been well-defined. Methods: In this meta-analysis, PubMed, Embase, Cochrane and China National Knowledge Infrastructure were searched on July 31,2022. We excluded studies including patients undergoing kidney replacement therapy at enrollment. The data was used to conduct a random-effects model for pool outcomes between patients with AKD and non-AKD (NKD). This study is registered with PROSPERO, CRD 42021271773. Findings: The search generated 739 studies of which 21 studies were included involving 1,114,012 patients. The incidence rate of community-acquired AKD was 4.60%, 2.11% in hospital-acquired AKD without a prior AKI episode, and 26.11% in hospital-acquired AKD with a prior AKI episode. The all-cause mortality rate was higher in the AKD group (26.54%) than in the NKD group (7.78%) (odds ratio [OR]: 3.62, 95% confidence interval [CI]: 2.64 to 4.95, p < 0.001, I2 = 99.11%). The rate of progression to end-stage kidney disease (ESKD) was higher in the AKD group (1.3%) than in the NKD group (0.14%) (OR: 6.58, p < 0.001, I2 = 94.95%). The incident rate of CKD and progressive CKD was higher in the AKD group (37.2%) than in the NKD group (7.45%) (OR:4.22, p < 0.001, I2 = 96.67%). Compared to the NKD group, patients with AKD without prior AKI had a higher mortality rate (OR: 3.00, p < 0.001, I2 = 99.31%) and new-onset ESKD (OR:4.96, 95% CI, p = 0.002, I2 = 97.37%). Interpretation: AKD is common in community and hospitalized patients who suffer from AKI and also occurs in patients without prior AKI. The patients with AKD, also in those without prior AKI had a higher risk of mortality, and new-onset ESKD than the NKD group. Funding: This study was supported by Ministry of Science and Technology (MOST) of the Republic of China (Taiwan) [grant number, MOST 107-2314-B-002-026-MY3, 108-2314-B-002-058, 110-2314-B-002-241, 110-2314-B-002-239], National Science and Technology Council (NSTC) [grant number, NSTC 109-2314-B-002-174-MY3, 110-2314-B-002-124-MY3, 111-2314-B-002-046, 111-2314-B-002-058], National Health Research Institutes [PH-102-SP-09], National Taiwan University Hospital [109-S4634, PC-1246, PC-1309, VN109-09, UN109-041, UN110-030, 111-FTN0011] Grant MOHW110-TDU-B-212-124005, Mrs. Hsiu-Chin Lee Kidney Research Fund and Chi-mei medical center CMFHR11136. JAN is supported, in part, by grants from the National Institute of Health, NIDDK (R01 DK128208 and P30 DK079337) and NHLBI (R01 HL148448-01).http://www.sciencedirect.com/science/article/pii/S2589537022004898Acute kidney injuryAcute kidney diseaseChronic kidney diseaseEnd-stage kidney disease |
| spellingShingle | Ching-Chun Su Jui-Yi Chen Sheng-Yin Chen Chih-Chung Shiao Javier A. Neyra Ryo Matsuura Eisei Noiri Emily See Yih-Ting Chen Cheng-Kai Hsu Heng-Chih Pan Chih-Hsiang Chang Mitchell H. Rosner Vin-Cent Wu Outcomes associated with acute kidney disease: A systematic review and meta-analysisResearch in context EClinicalMedicine Acute kidney injury Acute kidney disease Chronic kidney disease End-stage kidney disease |
| title | Outcomes associated with acute kidney disease: A systematic review and meta-analysisResearch in context |
| title_full | Outcomes associated with acute kidney disease: A systematic review and meta-analysisResearch in context |
| title_fullStr | Outcomes associated with acute kidney disease: A systematic review and meta-analysisResearch in context |
| title_full_unstemmed | Outcomes associated with acute kidney disease: A systematic review and meta-analysisResearch in context |
| title_short | Outcomes associated with acute kidney disease: A systematic review and meta-analysisResearch in context |
| title_sort | outcomes associated with acute kidney disease a systematic review and meta analysisresearch in context |
| topic | Acute kidney injury Acute kidney disease Chronic kidney disease End-stage kidney disease |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022004898 |
| work_keys_str_mv | AT chingchunsu outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT juiyichen outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT shengyinchen outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT chihchungshiao outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT javieraneyra outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT ryomatsuura outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT eiseinoiri outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT emilysee outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT yihtingchen outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT chengkaihsu outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT hengchihpan outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT chihhsiangchang outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT mitchellhrosner outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext AT vincentwu outcomesassociatedwithacutekidneydiseaseasystematicreviewandmetaanalysisresearchincontext |