Long-term prognosis after acute kidney injury (AKI): what is the role of baseline kidney function and recovery? A systematic review

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acute kidney injury 11 nephrologydiseases
chronic kidney disease 10 nephrologydiseases

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acute kidney injury 41 Title: BMJ OpenLong-term prognosis after acute kidney injury (AKI): what is the role of baseline kidney function and recovery? A systematic reviewSimon SawhneyMhairi
acute kidney injury 392 (collection): /2015Publication date (epub): 1/2015AbstractObjectivesTo summarise the evidence from studies of acute kidney injury (AKI) with regard to the effect of pre-AKI renal function and post-AKI renal function recovery on long-term
acute kidney injury 2527 exclusion and quality assessment criteria to summarise the available evidence regarding the role of pre- acute kidney injury (AKI) baseline and post-AKI recovery of renal function in long-term AKI outcomes.Few studies reported
acute kidney injury 6258 Medline subject heading (MeSH) terms and free text for AKI (acute renal failure, acute kidney disease, acute kidney injury , acute dialysis, RIFLE, AKIN) and prognosis (prognosis, survival, mortality, follow up, progression,
acute kidney injury 7938 outcomes, were used to assess the included studies (figure 1).Figure 1Quality assessment criteria (AKI, acute kidney injury ; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate).AnalysisStudy characteristics
acute kidney injury 12943 fall of cr over a 24 h rather than a recovery variable.–, Outcome not addressed by study; AKI, acute kidney injury ; CKD, chronic kidney disease; Cr, creatinine; eGFR, estimated glomerular filtration rate; ITU, intensive
acute kidney injury 16539 AKI 2.59†*Mean/median.†Statistically significant p<0.05.–, Outcome not addressed by study; AKI, acute kidney injury ; CKD, chronic kidney disease; Cr, serum creatinine; eGFR, estimated glomerular filtration rate; ESKD,
acute kidney injury 16875 quality criterion; RRT, renal replacement therapy.Figure 2Study selection and quality assessment (AKI, acute kidney injury ; CKD, chronic kidney disease).Among these studies, definitions varied: AKI was defined by acute RRT,[13]
acute kidney injury 18058 non-AKI comparators[11][17][21] or risk ratios.[16][35]Figure 3Mortality—by pre-AKI baseline (AKI, acute kidney injury ; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; w/o rec, without recovery;
acute kidney injury 18252 w/o rec, without recovery; with rec, with recovery).Figure 4Mortality—by post AKI recovery (AKI, acute kidney injury ; CKD, chronic kidney disease; w/o rec, without recovery; with rec, with recovery).Of the three studies
acute kidney injury 21885 only+recovery 4.5†*Mean/median.†Statistically significant p<0.05.–, Outcome not addressed by study; AKI, acute kidney injury ; CKD, chronic kidney disease; Cr, serum creatinine; eGFR, estimated glomerular filtration rate; ESKD,
chronic kidney disease 1012 kidney function, or described by the timing of the outcomes.OutcomesLong-term mortality and worsening chronic kidney disease (CKD).ResultsOf 7385 citations, few studies met inclusion criteria, reported baseline kidney function
chronic kidney disease 3529 and outcomes.[1] Some of the poor outcomes (including increased mortality[2][3] and development of chronic kidney disease (CKD)[4]) are increasingly described after hospital discharge, but this is variable and factors associated
chronic kidney disease 6379 acute dialysis, RIFLE, AKIN) and prognosis (prognosis, survival, mortality, follow up, progression, chronic kidney disease , renal replacement therapy, chronic dialysis, end-stage kidney disease; see online supplementary material).
chronic kidney disease 7964 the included studies (figure 1).Figure 1Quality assessment criteria (AKI, acute kidney injury; CKD, chronic kidney disease ; eGFR, estimated glomerular filtration rate).AnalysisStudy characteristics and quality assessment information
chronic kidney disease 12969 rather than a recovery variable.–, Outcome not addressed by study; AKI, acute kidney injury; CKD, chronic kidney disease ; Cr, creatinine; eGFR, estimated glomerular filtration rate; ITU, intensive therapy unit;; N, outcome
chronic kidney disease 16565 2.59†*Mean/median.†Statistically significant p<0.05.–, Outcome not addressed by study; AKI, acute kidney injury; CKD, chronic kidney disease ; Cr, serum creatinine; eGFR, estimated glomerular filtration rate; ESKD, end-stage kidney disease (dialysis
chronic kidney disease 16901 replacement therapy.Figure 2Study selection and quality assessment (AKI, acute kidney injury; CKD, chronic kidney disease ).Among these studies, definitions varied: AKI was defined by acute RRT,[13] different thresholds for
chronic kidney disease 18084 comparators[11][17][21] or risk ratios.[16][35]Figure 3Mortality—by pre-AKI baseline (AKI, acute kidney injury; CKD, chronic kidney disease ; eGFR, estimated glomerular filtration rate; w/o rec, without recovery; with rec, with recovery).Figure 4Mortality—by
chronic kidney disease 18278 with rec, with recovery).Figure 4Mortality—by post AKI recovery (AKI, acute kidney injury; CKD, chronic kidney disease ; w/o rec, without recovery; with rec, with recovery).Of the three studies stratified by pre-AKI baseline
chronic kidney disease 21911 4.5†*Mean/median.†Statistically significant p<0.05.–, Outcome not addressed by study; AKI, acute kidney injury; CKD, chronic kidney disease ; Cr, serum creatinine; eGFR, estimated glomerular filtration rate; ESKD, end-stage renal disease (dialysis

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