OUTCOMES OF ACUTE KIDNEY INJURY (AKI) REFERRED TO A KIDNEY CONSULTS SERVICE IN A TERTIARY/QUATERNARY HOSPITAL

R HUDSON ¹, H HEALY  ¹

¹Royal Brisbane Hospital, Herston, Australia

Aim: To describe kidney outcomes and survival at 3- and 6-months post-AKI

Background:Adverse outcomes of AKI include development/progression of chronic kidney disease (CKD), recurrent AKI, cardiovascular events and mortality. Risk factors associated with CKD following AKI include the severity, duration, multiple episodes and kidney replacement therapy (KRT).

Methods:Prospective observational study of all AKI patients referred to The Prince Charles Hospital kidney consults service between August and October 2020. Data were extracted from the patient clinical records. Data items included; patient demographics, co-morbidities at admission, frailty score at admission, grading of severity of AKI according to KDIGO stages 1, 2 or 3 and treatment with KRT. Outcomes of mortality and change in kidney function at 3- and 6-months post discharge were recorded Kidney outcomes were graded as complete recovery, de novo CKD, CKD progression or KRT.

Results: 68 patients were analysed, 43 were male (63%) and median age 71 years (61.0 – 79.5). Patients had mean of 6.4 co-morbidities and frailty score of 3.5 at admission. KDIGO AKI stages; 43% (N=29) stage 1, 31% (N=21) stage 2, 26% (N=18) stage 3 and 15% (N=10) requiring KRT. Twenty-three patients (34%) were admitted to ICU, 11 (16%) registered multiple AKIs. Kidney function recovered in 22 (39%) patients by discharge. At 3 months follow up 17 of 45 patients (survivors and available data) experienced progression of CKD and 4% of the acute dialysis patients had transitioned to chronic dialysis. In-hospital mortality rate was high with 12 inpatient deaths (21%) and another 2 patients died following discharge from hospital.

Conclusion: AKI is associated with high mortality and progression of CKD.

Biography:

I am a final year Renal Advanced Trainee working at a Tertiary Hospital in Queensland. My interests in Nephrology lie in a number of areas, but I am particularly interested in acute kidney injury, glomerulonephritis and kidney supportive care.