{"id":25661,"date":"2024-05-03T04:19:00","date_gmt":"2024-05-02T20:19:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=25661"},"modified":"2024-05-03T06:21:26","modified_gmt":"2024-05-02T22:21:26","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%80%a5%e6%80%a7%e8%82%be%e6%8d%9f%e4%bc%a4%e9%80%8f%e6%9e%90%e6%b2%bb%e7%96%97%e5%90%8e%e7%97%85%e6%83%85%e6%81%a2%e5%a4%8d%e5%8f%8a","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=25661","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u6025\u6027\u80be\u635f\u4f24\u900f\u6790\u6cbb\u7597\u540e\u75c5\u60c5\u6062\u590d\u53ca\u9884\u540e"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Nephrology<\/p>\n\n\n\n

March 8, 2024<\/p>\n\n\n\n

Recovery Dynamics and Prognosis After Dialysis for Acute Kidney Injury<\/h1>\n\n\n\n

Heng-Chih Pan, Hsing-Yu Chen, Nai-Chi Teng, et al<\/h3>\n\n\n\n

JAMA Netw Open. <\/em>2024;7(3):e240351. doi:10.1001\/jamanetworkopen.2024.0351<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Are baseline kidney function, acute kidney disease (AKD) severity, and post-AKD kidney function associated with adverse outcomes in patients with acute kidney injury requiring dialysis (AKI-D)?<\/p>\n\n\n\n

Findings<\/strong>  In this cohort study with 6703 participants, baseline kidney function and post-AKD kidney function were significant independent factors associated with all-cause mortality, major adverse cardiac events, end-stage kidney disease, and readmission in patients with AKI-D. Worse post-AKD kidney function was associated with a progressive increase in the risk of adverse outcomes; however, AKD severity was not associated with adverse outcomes.<\/p>\n\n\n\n

Meaning<\/strong>  These findings suggest that evaluating baseline and post-AKD kidney function is crucial for understanding the risk of adverse outcomes in patients with AKI-D.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  The interplay among baseline kidney function, severity of acute kidney disease (AKD), and post-AKD kidney function has significant associations with patient outcomes. However, a comprehensive understanding of how these factors are collectively associated with mortality, major adverse cardiac events (MACEs), and end-stage kidney disease (ESKD) in patients with dialysis-requiring acute kidney injury (AKI-D) is yet to be fully explored.<\/p>\n\n\n\n

Objective<\/strong>  To investigate the associations of baseline kidney function, AKD severity, and post-AKD kidney function with mortality, MACEs, and ESKD in patients with AKI-D.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>\u00a0\u00a0This nationwide, population-based cohort study of patients with AKI-D was conducted between January 1, 2015, and December 31, 2018, using data from various health care settings included in the Chinese Taipei statewide population-based cohort database. Data analysis was conducted from April 28, 2022, to June 30, 2023.<\/p>\n\n\n\n

Exposure<\/strong>  Exposure to severe AKI and baseline and post-AKD kidney function.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcomes were all-cause mortality and incident MACEs, and secondary outcomes were risks of permanent dialysis and readmission.<\/p>\n\n\n\n

Results<\/strong>  A total of 6703 of 22\u202f232 patients (mean [SD] age, 68.0 [14.7] years; 3846 [57.4%] male) with AKI-D with post-AKD kidney function follow-up and AKD stage data were enrolled. During a mean (SD) 1.2 (0.9) years of follow-up, the all-cause mortality rate was 28.3% (n\u2009=\u20091899), while the incidence rates of MACEs and ESKD were 11.1% (n\u2009=\u2009746) and 16.7% (n\u2009=\u20091119), respectively. After adjusting for known covariates, both post-AKD kidney function and baseline kidney function, but not AKD severity, were independently associated with all-cause mortality, MACEs, ESKD, and readmission. Moreover, worse post-AKD kidney function correlated with progressive and significant increases in the risk of adverse outcomes.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this cohort study of patients with AKI-D, more than one-quarter of patients died after 1.2 years of follow-up. Baseline and post-AKD kidney functions serve as important factors associated with the long-term prognosis of patients with AKI-D. Therefore, concerted efforts to understand the transition from post-AKD to chronic kidney disease are crucial.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Nephrology March 8,&n […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25661"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25661"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25661\/revisions"}],"predecessor-version":[{"id":25665,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25661\/revisions\/25665"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25661"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25661"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25661"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}