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Article Dans Une Revue Nephrology Dialysis Transplantation Année : 2018

Outcomes of acute kidney injury depend on initial clinical features: a national French cohort study

Résumé

Background: Acute kidney injury (AKI) is a common condition that is associated with poor short- and long-term outcomes. The aim of this nationwide cohort study was to profile the long-term outcome of patients admitted for AKI in France. Methods: Based on the comprehensive French hospital discharge database, all hospitalizations for an AKI episode were categorized in four groups according to the presence of at least one dialysis session [renal replacement therapy (RRT)] and according to the coding of AKI as the principal or associated diagnosis (PRINC_DIAG or ASS_DIAG). Results: In this nationwide cohort of 989~974 patients (median age 77 years) hospitalized with AKI during the 2009-16 period, 422~739 (43%) patients died (235~572 during the first hospitalization) and 40~015 (4%) patients reached end-stage renal disease (ESRD) (5962 during first hospitalization) up to 31 December 2016. Patients without RRT and discharged from hospital had a cumulative incidence of ESRD that ranged from 5.3% (5.2-5.4) in the ASS_DIAG group to 28.7% (27.9-29.5) in the RRT-PRINC_DIAG group at 60 months. The cumulative incidence of death ranged from 31.0% (30.2-32.2) in the RRT-ASS_DIAG group to 45.5% (45.3-45.7) in the ASS_DIAG group. Initial clinical features were associated with outcome independent of comorbidities and age. Conclusions: The death penalty of AKI is abysmal and AKI was an important predisposing factor to chronic ESRD. Our study strengthens the current recommendations for long-term follow-up of patients with AKI. The novelty of this study is to propose a clinical classification of AKI episodes that is easy to detect in administrative medical databases and that is strongly associated with immediate and long-term outcomes.

Dates et versions

hal-02361241 , version 1 (13-11-2019)

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Natacha Riffaut, Olivier Moranne, Alexandre Hertig, Thierry Hannedouche, Cécile Couchoud. Outcomes of acute kidney injury depend on initial clinical features: a national French cohort study. Nephrology Dialysis Transplantation, 2018, 33 (12), pp.2218--2227. ⟨10.1093/ndt/gfy137⟩. ⟨hal-02361241⟩
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