Acute Kidney Injury Hospitalization-Linked Mortality Is High

Mortality associated with acute kidney injury (AKI) hospitalization is high, with 28 percent dying within one year, according to a study published in the February issue of the Clinical Journal of the American Society of Nephrology.

Ryann Sohaney, D.O., from the University of Michigan in Ann Arbor, and colleagues conducted a retrospective cohort study for patients hospitalized from Oct. 1, 2008, to Sept. 31, 2017, using data from the national Veterans Health Administration. In-hospital and one-year mortality trends were examined for those with and without AKI.

Across the study period, 1,688,457 patients and 2,689,093 hospitalizations were identified. The researchers found that 6 percent of those with AKI died in the hospital and 28 percent died within one year. Among non-AKI hospitalizations, 0.8 and 14 percent had in-hospital and one-year mortality, respectively. A slight decline in crude in-hospital AKI-associated mortality was seen during the study period (hazard ratio, 0.98 per year; 95 percent confidence interval, 0.98 to 0.99); after adjustment for patient demographics, comorbid conditions, and acute hospitalization characteristics, the decline was attenuated (adjusted hazard ratio, 0.99; 95 percent confidence interval, 0.99 to 1.00). This stable trend persisted at one year (adjusted hazard ratio, 1.00 per year; 95 percent confidence interval, 0.99 to 1.00).

"There needs to be a focus on interventions that can improve AKI outcomes," write the authors of an accompanying editorial. "This will require first identifying the root causes of improved AKI mortality to target as preventive measures in a more focused manner to achieve even better outcomes."