Renal Association Clinical Practice Guidelines on Acute Kidney Injury

Lewington, Andrew; Kanagasundaram, Nigel S.

doi:10.1159/000328075

Cited by 88 publications

(107 citation statements)

References 176 publications

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“…The reasons for these differences are not clear but may be due to inherent differences between CKD and non-CKD populations or to differences in the outcomes evaluated and methods used to assess the exposure. Nonetheless, our findings support current CKD guidelines recommending lifestyle modifications regarding nonsmoking and physical activity for individuals with CKD (14,(31)(32)(33)(34). Further work is needed to investigate regarding optimal diet and BMI.…”

Section: Discussionsupporting

confidence: 81%

Adherence to a Healthy Lifestyle and All-Cause Mortality in CKD

Ricardo¹,

Madero

Yang

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objective Among general populations, a healthy lifestyle has been associated with lower risk of death. This study evaluated this association in individuals with CKD. Conclusions Compared with nonadherence, adherence to a healthy lifestyle was associated with lower all-cause mortality risk in CKD. Examination of individual components of the healthy lifestyle score, with adjustment for other components, suggested that the greatest reduction in all-cause mortality was related to nonsmoking.

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Section: Discussionsupporting

confidence: 81%

Adherence to a Healthy Lifestyle and All-Cause Mortality in CKD

Ricardo¹,

Madero

Yang

et al. 2013

Clinical Journal of the American Society of Nephrology

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“…In 2012, the Kidney Disease Improving Global Outcomes (KDIGO) Work Group developed a consensus-based AKI defining and staging system drawing on consolidating elements of previously proposed criteria (13). The KDIGO definition, as a standardized criterion, has been adopted by professional societies in both developed and developing countries (14)(15)(16)(17), making it possible to evaluate and compare the incidence and clinical effect of AKI across countries and populations. More accurate information on the burden of AKI and its consequences will help to optimize prevention and intervention of the syndrome.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Clinical Correlates of AKI in Chinese Hospitalized Adults

Nie

Liu

et al. 2015

Clinical Journal of the American Society of Nephrology

249

234

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Background and objectives Comprehensive epidemiologic data on AKI are particularly lacking in Asian countries. This study sought to assess the epidemiology and clinical correlates of AKI among hospitalized adults in China.Design, setting, participants, & measurements This was a multicenter retrospective cohort study of 659,945 hospitalized adults from a wide range of clinical settings in nine regional central hospitals across China in 2013. AKI was defined and staged according to Kidney Disease Improving Global Outcomes criteria. The incidence of AKI in the cohort was estimated using a novel two-step approach with adjustment for the frequency of serum creatinine tests and other potential confounders. Risk factor profiles for hospital-acquired (HA) and communityacquired (CA) AKI were examined. The in-hospital outcomes of AKI, including mortality, renal recovery, length of stay, and daily cost, were assessed.Results The incidence of CA-AKI and HA-AKI was 2.5% and 9.1%, respectively, giving rise to an overall incidence of 11.6%. Although the risk profiles for CA-AKI and HA-AKI differed, preexisting CKD was a major risk factor for both, contributing to 20% of risk in CA-AKI and 12% of risk in HA-AKI. About 40% of AKI cases were possibly drug-related and 16% may have been induced by Chinese traditional medicines or remedies. The in-hospital mortality of AKI was 8.8%. The risk of in-hospital death was higher among patients with more severe AKI. Preexisting CKD and need for intensive care unit admission were associated with higher death risk in patients at any stage of AKI. Transiency of AKI did not modify the risk of in-hospital death. AKI was associated with longer length of stay and higher daily costs, even after adjustment for confounders.Conclusion AKI is common in hospitalized adults in China and is associated with significantly higher in-hospital mortality and resource utilization.

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“…Finally, in 2012, the Kidney Disease Improving Global Outcomes (KDIGO) Work Group proposed another definition that builds upon the AKIN definition (18). The KDIGO definition has been adopted by the Renal Association of the United Kingdom (19) and has been the subject of commentary by other professional societies from the United States (20), Europe (21), and Canada (22).…”

Section: Introductionmentioning

confidence: 99%

Incidence, Outcomes, and Comparisons across Definitions of AKI in Hospitalized Individuals

Zeng

McMahon

Brunelli³

et al. 2014

Clinical Journal of the American Society of Nephrology

379

258

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SummaryBackground and objectives At least four definitions of AKI have recently been proposed. This study sought to characterize the epidemiology of AKI according to the most recent consensus definition proposed by the Kidney Disease Improving Global Outcomes (KDIGO) Work Group, and to compare it with three other definitions.Design, setting, participants, & measurements This was a retrospective cohort study of 31,970 hospitalizations at an academic medical center in 2010. AKI was defined and staged according to KDIGO criteria, the Acute Dialysis Quality Initiative's RIFLE criteria, the Acute Kidney Injury Network (AKIN) criteria, and a definition based on a model of creatinine kinetics (CK). Outcomes of interest were incidence, in-hospital mortality, length of stay, costs, readmission rates, and posthospitalization disposition.Results AKI incidence was highest according to the KDIGO definition (18.3%) followed by the AKIN (16.6%), RIFLE (16.1%), and CK (7.0%) definitions. AKI incidence appeared markedly higher in those with low baseline serum creatinine according to the KDIGO, AKIN, and RIFLE definitions, in which AKI may be defined by a 50% increase over baseline. AKI according to all definitions was associated with a significantly higher risk of death and higher resource utilization. The adjusted odds ratios for in-hospital mortality in those with AKI were highest with the CK definition (5.2; 95% confidence interval [95% CI], 4.1 to 6.6), followed by the RIFLE (2.9; 95% CI, 2.2 to 3.6), KDIGO (2.8; 95% CI, 2.2 to 3.6), and AKIN (2.6; 95% CI, 2.0 to 3.3) definitions. Concordance in diagnosis and staging was high among the KDIGO, AKIN, and RIFLE definitions. ConclusionsThe incidence of AKI in hospitalized individuals varies depending on the definition used. AKI according to all definitions is associated with higher in-hospital mortality and resource utilization. AKI may be inappropriately diagnosed in those with low baseline serum creatinine using definitions that incorporate percentage increases over baseline.

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Renal Association Clinical Practice Guidelines on Acute Kidney Injury

Cited by 88 publications

References 176 publications

Adherence to a Healthy Lifestyle and All-Cause Mortality in CKD

Adherence to a Healthy Lifestyle and All-Cause Mortality in CKD

Epidemiology and Clinical Correlates of AKI in Chinese Hospitalized Adults

Incidence, Outcomes, and Comparisons across Definitions of AKI in Hospitalized Individuals

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