Abstract
To evaluate the long-term consequences of acute kidney injury (AKI) in human immunodeficiency virus (HIV)-infected persons, we studied 17,325 patients in a national HIV registry during their first hospitalization. We determined the association of AKI with risk for heart failure, cardiovascular events, end-stage renal disease (ESRD), and mortality beginning 90 days after discharge. Based on AKI Network criteria, 2453 had stage 1; 273 had stage 2 or 3; and 334 had dialysis-requiring AKI. Over a mean follow-up period of 5.7 years, 333 had heart failure, 673 had cardiovascular diseases (CVDs), 348 developed ESRD, and 8405 deaths occurred. In multivariable-adjusted analyses, AKI stage 1 was associated with death and ESRD, but not heart failure or other CVD. Dialysis-requiring AKI had much stronger and significant associations with increased risk for long-term ESRD, and death in addition to heart failure and cardiovascular events. When AKI was reclassified to account for recovery, stage 1 with recovery was still associated with death, but not ESRD. Thus, in this national sample of HIV-infected persons, we found the clinical repercussions of AKI appear to extend beyond the hospital setting contributing to excess cardiovascular risks, ESRD, and mortality. Additionally, AKI affected almost one of six patients with HIV who survived at least 90 days following discharge.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 478-485 |
| Number of pages | 8 |
| Journal | Kidney International |
| Volume | 78 |
| Issue number | 5 |
| DOIs | |
| State | Published - Jan 1 2010 |
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Keywords
- acute kidney injury
- cardiovascular disease
- end-stage renal disease
- HIV
- mortality
ASJC Scopus subject areas
- Nephrology
Cite this
Long-term clinical consequences of acute kidney injury in the HIV-infected. / Choi, Andy I.; Li, Yongmei; Parikh, Chirag; Volberding, Paul A.; Shlipak, Michael G.
In: Kidney International, Vol. 78, No. 5, 01.01.2010, p. 478-485.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Long-term clinical consequences of acute kidney injury in the HIV-infected
AU - Choi, Andy I.
AU - Li, Yongmei
AU - Parikh, Chirag
AU - Volberding, Paul A.
AU - Shlipak, Michael G.
PY - 2010/1/1
Y1 - 2010/1/1
N2 - To evaluate the long-term consequences of acute kidney injury (AKI) in human immunodeficiency virus (HIV)-infected persons, we studied 17,325 patients in a national HIV registry during their first hospitalization. We determined the association of AKI with risk for heart failure, cardiovascular events, end-stage renal disease (ESRD), and mortality beginning 90 days after discharge. Based on AKI Network criteria, 2453 had stage 1; 273 had stage 2 or 3; and 334 had dialysis-requiring AKI. Over a mean follow-up period of 5.7 years, 333 had heart failure, 673 had cardiovascular diseases (CVDs), 348 developed ESRD, and 8405 deaths occurred. In multivariable-adjusted analyses, AKI stage 1 was associated with death and ESRD, but not heart failure or other CVD. Dialysis-requiring AKI had much stronger and significant associations with increased risk for long-term ESRD, and death in addition to heart failure and cardiovascular events. When AKI was reclassified to account for recovery, stage 1 with recovery was still associated with death, but not ESRD. Thus, in this national sample of HIV-infected persons, we found the clinical repercussions of AKI appear to extend beyond the hospital setting contributing to excess cardiovascular risks, ESRD, and mortality. Additionally, AKI affected almost one of six patients with HIV who survived at least 90 days following discharge.
AB - To evaluate the long-term consequences of acute kidney injury (AKI) in human immunodeficiency virus (HIV)-infected persons, we studied 17,325 patients in a national HIV registry during their first hospitalization. We determined the association of AKI with risk for heart failure, cardiovascular events, end-stage renal disease (ESRD), and mortality beginning 90 days after discharge. Based on AKI Network criteria, 2453 had stage 1; 273 had stage 2 or 3; and 334 had dialysis-requiring AKI. Over a mean follow-up period of 5.7 years, 333 had heart failure, 673 had cardiovascular diseases (CVDs), 348 developed ESRD, and 8405 deaths occurred. In multivariable-adjusted analyses, AKI stage 1 was associated with death and ESRD, but not heart failure or other CVD. Dialysis-requiring AKI had much stronger and significant associations with increased risk for long-term ESRD, and death in addition to heart failure and cardiovascular events. When AKI was reclassified to account for recovery, stage 1 with recovery was still associated with death, but not ESRD. Thus, in this national sample of HIV-infected persons, we found the clinical repercussions of AKI appear to extend beyond the hospital setting contributing to excess cardiovascular risks, ESRD, and mortality. Additionally, AKI affected almost one of six patients with HIV who survived at least 90 days following discharge.
KW - acute kidney injury
KW - cardiovascular disease
KW - end-stage renal disease
KW - HIV
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=77955664632&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955664632&partnerID=8YFLogxK
U2 - 10.1038/ki.2010.171
DO - 10.1038/ki.2010.171
M3 - Article
C2 - 20520594
AN - SCOPUS:77955664632
VL - 78
SP - 478
EP - 485
JO - Kidney International
JF - Kidney International
SN - 0085-2538
IS - 5
ER -