Poster Abstracts

Long-term prognosis of acute kidney injury: a 10 year

population-based study
Simon Sawhney, Nick Fluck, Adeera Levin, Alison Macleod, Angharad Marks, Gordon Prescott, Corri Black

Abstract
Background Acute kidney injury is serious and common, but the long-term prognosis after isolated episodes of the Published Online
disorder is not well described. Therefore, giving individual patients an accurate prognosis, and planning future care, February 25, 2016

is difficult. We describe the prognosis of patients after admission to hospital with acute kidney injury. Poster 15
University of Aberdeen,
Aberdeen, UK
Methods This cohort study was done in one health authority of Scotland (population 438 332). We identified
(S Sawhney MBChB,
individuals admitted to hospital in 2003 with and without acute kidney injury according to international criteria Prof A Macleod MBChB,
(Kidney Disease Improving Global Outcomes). We determined short-term (30 days), medium-term (≤1 year), A Marks MBChB, G Prescott PhD,
and long-term (>1 year) mortality and chronic renal replacement therapy (RRT). Within split-time intervals, we also Prof C Black MBChB);
NHS Grampian, Aberdeen,
characterised the impact over time of baseline renal function, severity and recurrence of acute kidney injury, and
UK (N Fluck MBChB);
renal recovery on mortality and chronic RRT. and University of British
Columbia, Vancouver,
Findings Of 17 630 patients, 3426 had acute kidney injury including 688 (20%) with recurrent episodes. Acute kidney BC, Canada (Prof A Levin MD)
injury increased short-term mortality more in patients with normal baseline function than in those with severe baseline Correspondence to:
Dr Simon Sawhney,
renal impairment (adjusted hazard ratio 8·4, 95% CI 6·7–10·6 vs 2·0, 1·4–3·0). The association of acute kidney injury with
Polwarth Building, Division
mortality attenuated over time, and beyond 1 year an episode did not affect mortality in those with severe baseline renal of Applied Health Sciences,
impairment (1·1, 0·9–1·5). During 10 years of follow-up, 161 patients received chronic RRT, which was associated with University of Aberdeen,
acute kidney injury, but only six of these patients also had normal baseline function. There was differential effect Aberdeen AB25 2ZD, UK
simon.sawhney@abdn.ac.uk
of acute kidney injury depending on the timeframe examined: severe and unrecovered disease led to poor short-term
outcomes, whereas recurrent disease and baseline renal impairment affected later outcomes.

Interpretation We show that the impact of acute kidney injury on mortality attenuates over time, and that chronic
RRT is rare without baseline impairment. Short-term and long-term outcomes are differentially dependent on
baseline function, recovery of acute kidney injury, and recurrence. Further study should determine the role for these
factors in targeted surveillance.

Funding SS is supported by a Clinical Research Training Fellowship from the Wellcome Trust (ref 102729/Z/13/Z).
Contributors
SS conceived, designed, and conducted the study with intellectual input from CB, NF, AL, AMac, and AMar. SS analysed the data with input from
CB, GP, and AMar. SS wrote the abstract with input from CB, AL, and AMac. All authors have seen and approved the final version of the abstract for
publication.
Declaration of interests
We declare no competing interests.

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