The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans

Steven G. Coca, Joseph T. King, Ronnie A. Rosenthal, Melissa F. Perkal, Chirag Parikh

Research output: Contribution to journalArticle

Abstract

Acute kidney injury (AKI) is primarily defined and staged according to the magnitude of the rise in serum creatinine. Here we sought to determine if the duration of AKI adds additional prognostic information above that from the magnitude of injury alone. We prospectively studied 35,302 diabetic patients from 123 Veterans Affairs Medical Centers undergoing their first noncardiac surgery. The main outcome was long-term mortality in those who survived the index hospitalization. AKI was stratified by magnitude according to AKI Network stages and by the duration (short (less than 2 days), medium (3-6 days) or long (7 days or more)). Overall, 17.8% of patients experienced at least stage 1 AKI or greater following surgery. Both the magnitude and duration of AKI were significantly associated with long-term survival in a dose-dependent manner. Within each stage, longer duration of AKI was significantly associated with a graded higher rate of mortality. However, within each of the duration categories, the stage was not associated with mortality. When considered separately in multivariate analyses, both a higher stage and duration were independently associated with increased risk of long-term mortality. Hence, the duration of AKI adds additional information to predict long-term mortality.

Original languageEnglish (US)
Pages (from-to)926-933
Number of pages8
JournalKidney International
Volume78
Issue number9
DOIs
StatePublished - Jan 1 2010

Fingerprint

Veterans
Acute Kidney Injury
Survival
Mortality
Creatinine
Hospitalization
Multivariate Analysis
Wounds and Injuries
Serum

Keywords

  • acute kidney injury
  • acute renal failure
  • creatinine
  • survival

ASJC Scopus subject areas

  • Nephrology

Cite this

The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans. / Coca, Steven G.; King, Joseph T.; Rosenthal, Ronnie A.; Perkal, Melissa F.; Parikh, Chirag.

In: Kidney International, Vol. 78, No. 9, 01.01.2010, p. 926-933.

Research output: Contribution to journalArticle

Coca, Steven G. ; King, Joseph T. ; Rosenthal, Ronnie A. ; Perkal, Melissa F. ; Parikh, Chirag. / The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans. In: Kidney International. 2010 ; Vol. 78, No. 9. pp. 926-933.
@article{f9bd9929937d469bb1b75ba8e3a15fe6,
title = "The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans",
abstract = "Acute kidney injury (AKI) is primarily defined and staged according to the magnitude of the rise in serum creatinine. Here we sought to determine if the duration of AKI adds additional prognostic information above that from the magnitude of injury alone. We prospectively studied 35,302 diabetic patients from 123 Veterans Affairs Medical Centers undergoing their first noncardiac surgery. The main outcome was long-term mortality in those who survived the index hospitalization. AKI was stratified by magnitude according to AKI Network stages and by the duration (short (less than 2 days), medium (3-6 days) or long (7 days or more)). Overall, 17.8{\%} of patients experienced at least stage 1 AKI or greater following surgery. Both the magnitude and duration of AKI were significantly associated with long-term survival in a dose-dependent manner. Within each stage, longer duration of AKI was significantly associated with a graded higher rate of mortality. However, within each of the duration categories, the stage was not associated with mortality. When considered separately in multivariate analyses, both a higher stage and duration were independently associated with increased risk of long-term mortality. Hence, the duration of AKI adds additional information to predict long-term mortality.",
keywords = "acute kidney injury, acute renal failure, creatinine, survival",
author = "Coca, {Steven G.} and King, {Joseph T.} and Rosenthal, {Ronnie A.} and Perkal, {Melissa F.} and Chirag Parikh",
year = "2010",
month = "1",
day = "1",
doi = "10.1038/ki.2010.259",
language = "English (US)",
volume = "78",
pages = "926--933",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "9",

}

TY - JOUR

T1 - The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans

AU - Coca, Steven G.

AU - King, Joseph T.

AU - Rosenthal, Ronnie A.

AU - Perkal, Melissa F.

AU - Parikh, Chirag

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Acute kidney injury (AKI) is primarily defined and staged according to the magnitude of the rise in serum creatinine. Here we sought to determine if the duration of AKI adds additional prognostic information above that from the magnitude of injury alone. We prospectively studied 35,302 diabetic patients from 123 Veterans Affairs Medical Centers undergoing their first noncardiac surgery. The main outcome was long-term mortality in those who survived the index hospitalization. AKI was stratified by magnitude according to AKI Network stages and by the duration (short (less than 2 days), medium (3-6 days) or long (7 days or more)). Overall, 17.8% of patients experienced at least stage 1 AKI or greater following surgery. Both the magnitude and duration of AKI were significantly associated with long-term survival in a dose-dependent manner. Within each stage, longer duration of AKI was significantly associated with a graded higher rate of mortality. However, within each of the duration categories, the stage was not associated with mortality. When considered separately in multivariate analyses, both a higher stage and duration were independently associated with increased risk of long-term mortality. Hence, the duration of AKI adds additional information to predict long-term mortality.

AB - Acute kidney injury (AKI) is primarily defined and staged according to the magnitude of the rise in serum creatinine. Here we sought to determine if the duration of AKI adds additional prognostic information above that from the magnitude of injury alone. We prospectively studied 35,302 diabetic patients from 123 Veterans Affairs Medical Centers undergoing their first noncardiac surgery. The main outcome was long-term mortality in those who survived the index hospitalization. AKI was stratified by magnitude according to AKI Network stages and by the duration (short (less than 2 days), medium (3-6 days) or long (7 days or more)). Overall, 17.8% of patients experienced at least stage 1 AKI or greater following surgery. Both the magnitude and duration of AKI were significantly associated with long-term survival in a dose-dependent manner. Within each stage, longer duration of AKI was significantly associated with a graded higher rate of mortality. However, within each of the duration categories, the stage was not associated with mortality. When considered separately in multivariate analyses, both a higher stage and duration were independently associated with increased risk of long-term mortality. Hence, the duration of AKI adds additional information to predict long-term mortality.

KW - acute kidney injury

KW - acute renal failure

KW - creatinine

KW - survival

UR - http://www.scopus.com/inward/record.url?scp=77958089666&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77958089666&partnerID=8YFLogxK

U2 - 10.1038/ki.2010.259

DO - 10.1038/ki.2010.259

M3 - Article

C2 - 20686452

AN - SCOPUS:77958089666

VL - 78

SP - 926

EP - 933

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - 9

ER -