Nationwide epidemiology and prognosis of dialysis‐requiring acute kidney injury (NEP‐AKI‐D) study: Design and methods

Shiao, Chih‐Chung; Wu, Pei‐Chen; Wu, Vin‐Cent; Lin, Jui-Hsiang; Pan, Heng‐Chih; Yang, Yu‐Cih; Lai, Tai‐Shuan; Huang, Tao‐Min; Wu, Che‐Hsiung; Yang, Wei-Shun; Wu, Chih‐Jen; Kao, Chih-Chin; Sun, Chiao‐Yin; Huang, Chun-Te; Lee, Kuo‐Hua; Lin, Chan‐Yu; Chen, Te‐Chuan; Hu, Fu‐Chang; Liou, Hung-Hsiang; Lu, Kuo‐Cheng; Chien, Kuo–Liong; Wang, Jian-Jhong; Kuo, Fang-Ying; Lin, Hugo You-Hsien; Chen, Cheng-Min; You, Zi-Hong; Tsai, Jen-Pi; Weng, Chih-Jen; Chen, Hung‐Yuan; Chang, Chia‐Ming; Hsu, Wen-Ding; Wu, Mai‐Szu; Huang, Chiu‐Ching; Wu, Kwan‐Dun

doi:10.1111/nep.12670

Cited by 12 publications

(13 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Consortium for Acute Kidney Injury and Renal Diseases, representing a party of nephrologists and intensivists from 30 medical centres in Taiwan, [17] participated in the project and conducted this original nationwide study to test the hypothesis that clinical characteristics and prognosis are different between AKI patients with and without preexisting CKD under the current AKI definition of KDIGO classification system. The secondary objective of this study was to explore the risk factors, contributors, resource utilization, and outcomes of AKI in Taiwan.…”

Section: Introductionmentioning

confidence: 99%

A nationwide survey of clinical characteristics, management, and outcomes of acute kidney injury (AKI) – patients with and without preexisting chronic kidney disease have different prognoses

Pan

et al. 2016

Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

A nationwide survey of clinical characteristics, management, and outcomes of acute kidney injury (AKI) – patients with and without preexisting chronic kidney disease have different prognoses

Pan

et al. 2016

Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…More detailed laboratory data of CTS and non-CTS patients were compared across all hospitals in the CAKS cohort 23 for the validation of different clinical manifestations at postsurgical AKI during hospitalization. After PSM at a 1:1 ratio ( Table S4 ), 144 patients (72 CTS patients, 72 non-CTS patients) were further analyzed.…”

Section: Resultsmentioning

confidence: 99%

“…The CAKS member hospitals have a 1:1 ratio of medical centers to regional hospitals in each region and in the four seasonally sampled months (October 2014 and January, April, and July 2015). 23 Patients undergoing dialysis after major surgery were selected to be in the validation cohort. This cohort included 79 CTS patients and 154 non-CTS patients.…”

Section: Methodsmentioning

confidence: 99%

Short- and long-term outcomes after postsurgical acute kidney injury requiring dialysis

Lin

Huang

Lin

et al. 2018

CLEP

Self Cite

View full text Add to dashboard Cite

ObjectivePrompt assessment of perioperative complications is critical for the comprehensive care of surgical patients. Acute kidney injury requiring dialysis (AKI-D) is associated with high mortality, yet little is known about how long-term outcomes of patients have evolved. The association of AKI-D with postsurgical outcomes has not been well studied.MethodsWe investigated patients from the National Health Insurance Research Database and validated by the multicenter Clinical Trial Consortium for Renal Diseases cohort. All patients with AKI-D 18 years or older undergoing four major surgeries (cardiothoracic, esophagus, intestine, and liver) were retrospectively investigated (N=106,573). Patient demographics, surgery type, comorbidities before admission, and postsurgical outcomes, including the in-hospital, 30-day, and long-term mortality together with dialysis dependence were collected.ResultsAKI-D is the top risk factor for 30-day and long-term mortality after major surgery. Of 1,664 individuals with AKI-D and 6,656 matched controls, AKI-D during the hospital stay was associated with in-hospital (adjusted hazard ratio [aHR]=3.04, 95% CI 2.79–3.31), 30-day (aHR=3.65, 95% CI 3.37–3.94), and long-term (aHR=3.22, 95% CI 3.01–3.44) mortality. Patients undergoing cardiothoracic surgery (CTS) showed less in-hospital (aHR=0.85, 95% CI 0.75–0.97), 30-day (aHR=0.79, 95% CI 0.70–0.89), and long-term (aHR=0.80, 95% CI 0.72–0.90) mortality compared with non-CTS patients with AKI-D. CTS patients had a high risk of 30-day dialysis dependence (subhazard ratio [sHR]=1.67, 95% CI 1.18–2.38), but the risk of long-term dialysis dependence was similar (sHR=1.38, 95% CI 0.96–2.00) after AKI-D by taking mortality as a competing risk. Non-CTS patients had more comorbidities of sepsis, azotemia, hypoalbuminemia, and metabolic acidosis compared with CTS patients.ConclusionAKI exhibits paramount effects on postsurgical outcomes that extend well beyond discharge from the hospital. The goal of the perioperative assessment should include the reassurance of enhancing renal function recovery among different surgeries, and optimized follow-up is warranted in attenuating the complications after postsurgical AKI has occurred.

show abstract

“…This nationwide prospective multicenter study was conducted using the database of the nationwide epidemiology and prognosis of dialysis-requiring acute kidney injury (NEP-AKI-D) study 16 , 17 . Briefly, the NEP-AKI-D study was designed to enroll critically ill adult patients with AKI-D receiving RRT in the ICUs of both tertiary medical centers and regional hospitals located in the four geographical regions (north, middle, south, and east) of Taiwan.…”

Section: Methodsmentioning

confidence: 99%

Association between regional economic status and renal recovery of dialysis-requiring acute kidney injury among critically ill patients

Shiao

Chang²,

Yang

et al. 2020

Sci Rep

Self Cite

View full text Add to dashboard Cite

The association between regional economic status and the probability of renal recovery among patients with dialysis-requiring AKI (AKI-D) is unknown. The nationwide prospective multicenter study enrolled critically ill adult patients with AKI-D in four sampled months (October 2014, along with January, April, and July 2015) in Taiwan. The regional economic status was defined by annual disposable income per capita (ADIPC) of the cities the hospitals located. Among the 1,322 enrolled patients (67.1 ± 15.5 years, 36.2% female), 833 patients (63.1%) died, and 306 (23.1%) experienced renal recovery within 90 days following discharge. We categorized all patients into high (n = 992) and low economic status groups (n = 330) by the best cut-point of ADIPC determined by the generalized additive model plot. By using the Fine and Gray competing risk regression model with mortality as a competing risk factor, we found that the independent association between regional economic status and renal recovery persisted from model 1 (no adjustment), model 2 (adjustment to basic variables), to model 3 (adjustment to basic and clinical variables; subdistribution hazard ratio, 1.422; 95% confidence interval, 1.022–1.977; p = 0.037). In conclusion, high regional economic status was an independent factor for renal recovery among critically ill patients with AKI-D.

show abstract

Nationwide epidemiology and prognosis of dialysis‐requiring acute kidney injury (NEP‐AKI‐D) study: Design and methods

Abstract: The NEP-AKI-D study enrols a large number of representative AKI patients throughout Taiwan. The results of the current study are expected to provide more insight into the risk and prognostic factors of AKI and further attenuated further chronic kidney disease transition.

Cited by 12 publications

References 31 publications

A nationwide survey of clinical characteristics, management, and outcomes of acute kidney injury (AKI) – patients with and without preexisting chronic kidney disease have different prognoses

A nationwide survey of clinical characteristics, management, and outcomes of acute kidney injury (AKI) – patients with and without preexisting chronic kidney disease have different prognoses

Short- and long-term outcomes after postsurgical acute kidney injury requiring dialysis

Association between regional economic status and renal recovery of dialysis-requiring acute kidney injury among critically ill patients

Contact Info

Product

Resources

About