Table 3 Summary of investigations evaluating the impact of post-AKI renal recovery on mortality and/or CKD and ESRD compared to no-AKI controls
From: The aftermath of acute kidney injury: a narrative review of long-term mortality and renal function
Author | Setting | Number | Follow-up | AKI definition | Renal recovery definition | Mortality risk | CKD/ESRD risk* | |
|---|---|---|---|---|---|---|---|---|
Bihorac et al. [33] | ICU (surgical) | 10,518 | Max 14.0 years | RIFLE criteria | Complete Partial Nonrecovery | ΔSCr at discharge ≤ 50% ΔSCr at discharge > 50% RRT at discharge | HR (95% CI) = 1.20 (1.10–1.31) HR (95% CI) = 1.45 (1.32–1.58) HR (95% CI) = 2.76 (2.09–3.43) | – |
Brown et al. [48] | Cardiac surgery | 4873 | Mean 2.5 years | AKIN criteria | Transient Nonrecovery | ΔSCr at 1–2 days ≥ 50% or > 0.3 mg/dl ΔSCr at 3–6 days ≥ 50% or > 0.3 mg/dl ΔSCr at ≥ 7 days ≥ 50% or > 0.3 mg/dl ΔSCr at discharge ≥ 50% | HR (95% CI) = 1.51 (1.19–1.91) HR (95% CI) = 1.74 (1.34–2.26) HR (95% CI) = 3.45 (2.75–4.34) HR (95% CI) = 5.75 (4.10–8.07) | – |
Bucaloiu et al. [49] | Overall hospitalization | 20,028 | Mean 3.3 years | AKIN criteria | Recovery | ΔeGFR at day 90 ≤ 10% | HR (95% CI) = 1.48 (1.19–1.82) | HR (95% CI) = 1.91 (1.75–2.09) |
Coca et al. [34] | Noncardiac surgery | 35,302 | Mean 3.7 years | AKIN criteria | Transient | ΔSCr at 1–2 days ≥ 50% or > 0.3 mg/dl ΔSCr at 3–6 days ≥ 50% or > 0.3 mg/dl ΔSCr at ≥ 7 days ≥ 50% or > 0.3 mg/dl | HR (95% CI) = 1.15 (1.07–1.23) HR (95% CI) = 1.50 (1.36–1.66) HR (95% CI) = 2.01 (1.77–2.28) | – |
Han et al. [50] | CABG | 1899 | Median: 5.0 years | KDIGO criteria | Recovery Nonrecovery | SCr at 3 months ≤ baseline SCr SCr at 3 months > baseline SCr | HR (95% CI) = 1.68 (1.35–2.10) HR (95% CI) = 2.06 (1.52–2.79) | – |
Hobson et al. [51] | Cardiothoracic surgery | 2973 | Max 10.0 years | RIFLE criteria | Complete Partial Nonrecovery | ΔSCr at discharge ≤ 50% ΔSCr at discharge > 50% RRT at discharge | HR (95% CI) = 1.28 (1.11–1.48) HR (95% CI) = 1.49 (1.27–1.74) HR (95% CI) = 3.79 (2.46–5.74) | – |
Jones et al. [52] | Overall hospitalization | 3809 | Median 2.5 years | AKIN criteria | Recovery | ΔSCr at day 7 < 10% | HR (95% CI) = 1.08 (0.93–1.27) | HR (95% CI) = 3.82 (2.81–5.19) |
Kuijk et al. [68] | Major vascular surgery | 1308 | Median 5.0 years | ΔSCr > 10% vs. baseline | Recovery Nonrecovery | ΔSCr at day 3 ≤ 10% ΔSCr at day 3 > 10% | – | RR (95% CI) = 3.40 (2.70–4.10) RR (95% CI) = 3.60 (2.80–4.40) |
Lafrance et al. [38] | Overall hospitalization | 864,933 | Mean 2.3 years | AKIN criteria | Recovery | ΔeGFR at discharge ≤ 10% | HR (95% CI) = 1.47 (1.43–1.51) | – |
Loef et al. [53] | Cardiac surgery | 843 | Max 14.3 years | ΔSCr ≥ 25% vs. baseline | Recovery Nonrecovery | SCr at discharge ≤ baseline SCr SCr at discharge > baseline SCr | HR (95% CI) = 1.66 (1.09–2.53) HR (95% CI) = 1.72 (1.00–2.96) | – |
Maioli et al. [54] | Coronary angiography | 1490 | Median 3.8 years | ΔSCr > 0.5 mg/dl vs. baseline | Recovery Nonrecovery | ΔSCr at 3 months < 25% ΔSCr at 3 months ≥ 25% | HR (95% CI) = 1.30 (1.10–1.70) HR (95% CI) = 2.30 (1.30–4.00) | – |
Mehta et al. [55] | CABG | 10,415 | Median: 7.0 years | ΔSCr ≥ 50% or ≥ 0.7 mg/dl vs. baseline | Complete Partial Nonrecovery | SCr at day 7 ≤ baseline SCr ΔSCr at day 7 < 50% or < 0.7 mg/dl ΔSCr at day 7 ≥ 50% or ≥ 0.7 mg/dl | HR (95% CI) = 1.21 (1.07–1.37) HR (95% CI) = 1.58 (1.36–1.82) HR (95% CI) = 1.42 (1.27–1.59) | – |
Pannu et al. [56] | Overall hospitalization | 190,714 | Mean 2.8 years | ΔSCr ≥ 100% vs. baseline or RRT requirement | No AKI Recovery Nonrecovery | No AKI criteria ΔSCr at 90 days ≤ 25% ΔSCr at 90 days > 25% | HR (95%CI) = 0.69 (0.64–0.75) Reference HR (95% CI) = 1.28 (1.13–1.46) | HR (95% CI) = 0.63 (0.54–0.74) Reference HR (95% CI) = 5.59 (3.77–5.58) |
Wu et al. [57] | ICU (surgical) | 9425 | Median 4.8 years | RIFLE criteria | AKI (CKD-) recovery AKI (CKD-) nonrecovery AKI (CKD+) recovery AKI (CKD+) nonrecovery | ΔSCr at discharge < 50% ΔSCr at discharge > 50% ΔSCr at discharge < 50% ΔSCr at discharge > 50% | HR (95% CI) = 1.96 (1.78–2.16) HR (95% CI) = 2.18 (1.24–3.84) HR (95% CI) = 3.00 (2.35–3.84) HR (95% CI) = 4.59 (3.20–6.45) | HR (95% CI) = 4.50 (2.43–8.35) HR (95% CI) = 60.95 (24.13–153.97) HR (95% CI) = 74.07 (38.82–141.32) HR (95% CI) = 212.73 (105.53–428.83) |
Xu et al. [58] | Cardiac surgery | 3245 | Max 2.0 years | KDIGO criteria | Recovery Nonrecovery | ΔSCr at discharge ≤ 44 μmol/L ΔSCr at discharge > 44 μmol/L | RR (95% CI) = 1.79 (1.20–2.49) RR (95% CI) = 8.64 (6.04–12.34) | RR (95% CI) = 1.92 (1.37–2.69) RR (95% CI) = 15.05 (10.88–20.82) |