The prognostic importance of duration of AKI: a systematic review and meta-analysis
Abstract Background Acute kidney injury (AKI), as defined by peak increase in serum creatinine, is independently associated with increased risk of mortality and length of stay. Studies have suggested that the duration of AKI may be an important additional or independent prognostic marker of increase...
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| Format: | Article |
| Language: | English |
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BMC
2018-04-01
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| Series: | BMC Nephrology |
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| Online Access: | http://link.springer.com/article/10.1186/s12882-018-0876-7 |
| _version_ | 1811270022694174720 |
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| author | Swati Mehta Kinsuk Chauhan Achint Patel Shanti Patel Rachel Pinotti Girish N. Nadkarni Chirag R. Parikh Steven G. Coca |
| author_facet | Swati Mehta Kinsuk Chauhan Achint Patel Shanti Patel Rachel Pinotti Girish N. Nadkarni Chirag R. Parikh Steven G. Coca |
| author_sort | Swati Mehta |
| collection | DOAJ |
| description | Abstract Background Acute kidney injury (AKI), as defined by peak increase in serum creatinine, is independently associated with increased risk of mortality and length of stay. Studies have suggested that the duration of AKI may be an important additional or independent prognostic marker of increased mortality in patients with AKI across clinical settings. We performed a systematic review and meta-analysis of published studies to assess the impact of duration of AKI on outcomes. Methods Various bibliographic databases (MEDLINE, Embase, Cochrane Library, CINAHL and Web of Science) were searched through database inception to December 2015. Human, longitudinal studies with patients aged 18 or above describing outcomes of duration of AKI were included. Duration of AKI categorized as “Short” if AKI duration was ≤2 days or labeled as “transient AKI”; “Medium” for AKI durations 3–6 days and “Long” for AKI duration of ≥7 days or “non-recovered”. Various outcomes looked at were Long term mortality, cardiovascular events, chronic kidney disease (CKD). Results Eighteen studies were deemed eligible for the systematic review. The outcome of long-term mortality with duration of AKI was reported in 8 studies. The pooled Risk Ratio (RR) for long-term mortality generally was higher for longer duration of AKI: short duration of AKI (n = 8 studies, RR 1.42, 95% CI 1.21–1.66), medium duration (n = 4 studies, RR 1.92, 95% CI 1.34–2.75), and long duration (n = 8 studies, RR 2.28, 95% CI 1.77–2.94) duration of AKI. Further, Duration of AKI was independently associated with higher risk of cardiovascular outcomes and incident CKD Stage 3 when stratified within each stage of AKI. Conclusion Duration of AKI was independently associated with long term mortality, cardiovascular(CV) events, and development of incident CKD Stage 3. |
| first_indexed | 2024-04-12T21:52:25Z |
| format | Article |
| id | doaj.art-df9f9db1d970425799e3ec00bc4e07a0 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-12T21:52:25Z |
| publishDate | 2018-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-df9f9db1d970425799e3ec00bc4e07a02022-12-22T03:15:26ZengBMCBMC Nephrology1471-23692018-04-0119111010.1186/s12882-018-0876-7The prognostic importance of duration of AKI: a systematic review and meta-analysisSwati Mehta0Kinsuk Chauhan1Achint Patel2Shanti Patel3Rachel Pinotti4Girish N. Nadkarni5Chirag R. Parikh6Steven G. Coca7Albany Medical centerIcahn School of Medicine at Mount SinaiIcahn School of Medicine at Mount SinaiIcahn School of Medicine at Mount SinaiIcahn School of Medicine at Mount SinaiIcahn School of Medicine at Mount SinaiProgram of Applied Translational Research, Yale School of MedicineIcahn School of Medicine at Mount SinaiAbstract Background Acute kidney injury (AKI), as defined by peak increase in serum creatinine, is independently associated with increased risk of mortality and length of stay. Studies have suggested that the duration of AKI may be an important additional or independent prognostic marker of increased mortality in patients with AKI across clinical settings. We performed a systematic review and meta-analysis of published studies to assess the impact of duration of AKI on outcomes. Methods Various bibliographic databases (MEDLINE, Embase, Cochrane Library, CINAHL and Web of Science) were searched through database inception to December 2015. Human, longitudinal studies with patients aged 18 or above describing outcomes of duration of AKI were included. Duration of AKI categorized as “Short” if AKI duration was ≤2 days or labeled as “transient AKI”; “Medium” for AKI durations 3–6 days and “Long” for AKI duration of ≥7 days or “non-recovered”. Various outcomes looked at were Long term mortality, cardiovascular events, chronic kidney disease (CKD). Results Eighteen studies were deemed eligible for the systematic review. The outcome of long-term mortality with duration of AKI was reported in 8 studies. The pooled Risk Ratio (RR) for long-term mortality generally was higher for longer duration of AKI: short duration of AKI (n = 8 studies, RR 1.42, 95% CI 1.21–1.66), medium duration (n = 4 studies, RR 1.92, 95% CI 1.34–2.75), and long duration (n = 8 studies, RR 2.28, 95% CI 1.77–2.94) duration of AKI. Further, Duration of AKI was independently associated with higher risk of cardiovascular outcomes and incident CKD Stage 3 when stratified within each stage of AKI. Conclusion Duration of AKI was independently associated with long term mortality, cardiovascular(CV) events, and development of incident CKD Stage 3.http://link.springer.com/article/10.1186/s12882-018-0876-7Acute kidney injuryDurationMortality |
| spellingShingle | Swati Mehta Kinsuk Chauhan Achint Patel Shanti Patel Rachel Pinotti Girish N. Nadkarni Chirag R. Parikh Steven G. Coca The prognostic importance of duration of AKI: a systematic review and meta-analysis BMC Nephrology Acute kidney injury Duration Mortality |
| title | The prognostic importance of duration of AKI: a systematic review and meta-analysis |
| title_full | The prognostic importance of duration of AKI: a systematic review and meta-analysis |
| title_fullStr | The prognostic importance of duration of AKI: a systematic review and meta-analysis |
| title_full_unstemmed | The prognostic importance of duration of AKI: a systematic review and meta-analysis |
| title_short | The prognostic importance of duration of AKI: a systematic review and meta-analysis |
| title_sort | prognostic importance of duration of aki a systematic review and meta analysis |
| topic | Acute kidney injury Duration Mortality |
| url | http://link.springer.com/article/10.1186/s12882-018-0876-7 |
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