Seasonality of acute kidney injury in a tertiary hospital academic center: an observational cohort study

Lombardi, Gianmarco; Gambaro, Giovanni; Pertica, Nicoletta; Naticchia, Alessandro; Bargagli, Matteo; Ferraro, Pietro Manuel

doi:10.1186/s12940-021-00691-5

Cited by 10 publications

(14 citation statements)

References 21 publications

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“…Also 30-day mortality was higher in winter months. Similar results were highlighted in an Italian hospital setting, underlining how winter was associated with increased risk of AKI and that low air temperature and high relative humidity increased the risk of AKI [16].…”

Section: Discussionsupporting

confidence: 78%

“…Several epidemiological studies have reported a seasonal trend in different clinical conditions in the surgical [3], traumatological [4] and medical [5] fields, in particular cardiovascular [6][7][8][9][10][11][12], respiratory [13] and infectious illness [14] have got a winter peak in their frequency. Also, acute kidney injury (AKI) has been described to have an incidence peak during winter [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Seasonal pattern in elderly hospitalized with acute kidney injury: a retrospective nationwide study in Italy

et al. 2022

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Purpose Acute kidney injury (AKI) frequently complicates hospitalization and is associated with in-hospital mortality (IHM). It has been reported a seasonal trend in different clinical conditions. The aim of this study was to evaluate the possible relationship between seasons of the year and IHM in elderly hospitalized patients with AKI. Methods We selected all admissions complicated by AKI between 2000 and 2015 recorded in the Italian National Hospital Database. ICD-9-CM code 584.xx identified subjects with age ≥ 65 years and age, sex, comorbidity burden, need of dialysis treatment and IHM were compared in hospitalizations recorded during the four seasons. Moreover, we plotted the AKI observed/expected ratio and percentage of mortality during the study period. Results We evaluated 759,720 AKI hospitalizations (mean age 80.5 ± 7.8 years, 52.2% males). Patients hospitalized with AKI during winter months had higher age, prevalence of dialysis-dependent AKI, and number of deceased patients. In whole population IHM was higher in winter and lower in summer, while the AKI observed/expected ratio demonstrated two peaks, one in summer and one in winter. Logistic regression analysis demonstrated that parameters such as age, autumn, winter, comorbidity burden were positively associated with IHM. Conclusion We conclude that a seasonality exists in AKI, however, relationship between seasons and AKI could vary depending on the aspects considered. Both autumn and winter months are independent risk factors for IHM in patients with AKI regardless of age, sex and comorbidity burden. On the contrary, summer time reduces the risk of death during hospitalizations with AKI.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Seasonal pattern in elderly hospitalized with acute kidney injury: a retrospective nationwide study in Italy

et al. 2022

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“…The most common etiological factors were prerenal followed by sepsis, ischemic acute tubular necrosis [12]. Lombardy et al [13] studied causes of AKI in 2864 patients. They reported that AKI was more period in winter period (RR: 1.16; 95% CI: 1.05-1.29; p = 0.003) and AKI risk was found to be associated with lower air temperature and higher humidity [13].…”

Section: Discussionmentioning

confidence: 99%

“…Lombardy et al [13] studied causes of AKI in 2864 patients. They reported that AKI was more period in winter period (RR: 1.16; 95% CI: 1.05-1.29; p = 0.003) and AKI risk was found to be associated with lower air temperature and higher humidity [13]. In our study, the most frequent cause of prerenal AKI was dehydration, heart failure and sepsis.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury In Turkey: Epidemiological Characteristics, Etiology, Clinical Course And Prognosis

Gürsu

Yeğenağa

Dursun

et al. 2022

Preprint

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Background: In this study, we aimed to evaluate the etiology, comorbidities and outcome of acute kidney injury (AKI) in our country, and if there is, to demonstrate any potential differences in different geographical parts of the country. Methods: This prospective observational study was carried on by Acute Kidney Injury Working Group of Turkish Society of Nephrology. Demographical and clinical data of AKI patients at the time of diagnosis, at the 1st week and 1st, 3rd and 6th months were evaluated to determine patient and renal survival, and factors associated with prognosis. Results: 776 patients were included (54.7% male, median age: 67 years). Prerenal causes were more frequent, namely dehydration, heart failure and sepsis. 58.9% of patients had at least one renal etiology, most frequently nephrotoxic agent exposure. Etiologic factors were mostly similar through the country. 33.6% of patients needed renal replacement therapy. At the 6th month of diagnosis, 29.5% of patients had complete, 34.1% had partial recovery, end stage kidney disease ensued in 9.5% and 24.1% died. Death rate was higher in patients from Eastern Anatolian region, those in intensive care unit, patients with prerenal, renal and postrenal etiologies together, stage-3 AKI, sepsis, cirrhosis, heart failure, malignancy, need for renal replacement therapy and those without chronic kidney disease. Conclusion: Physicians dealing with AKI should be alert against dehydration, heart failure and sepsis, nephrotoxic agent exposure while taking care of these patients. Being aware of the characteristics of AKI patients and outcomes in their country would help to prevent AKI and treating better.

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“…Acute kidney injury (AKI) is a severe pathological condition often observed in the hospitalized population [1, 2]. The reported incidence is quite variable, ranging from 7% to 57% [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Serum Potassium Disorders Predict Subsequent Kidney Injury: A Retrospective Observational Cohort Study of Hospitalized Patients

Lombardi

Gambaro

Ferraro

2022

Kidney Blood Press Res

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Introduction Electrolytes disorders are common findings in kidney diseases and might represent a useful biomarker preceding kidney injury. Serum potassium [K+] imbalance is still poorly investigated for association with acute kidney injury (AKI) and most evidence come from intensive care units (ICU). The aim of our study was to comprehensively investigate this association in a large, unselected cohort of hospitalized patients. Methods: We performed a retrospective observational cohort study on the inpatient population admitted to Fondazione Policlinico Universitario A. Gemelli IRCCS between January 1, 2010 and December 31, 2014 with inclusion of adult patients with at least 2 [K+] and 3 serum creatinine (sCr) measurements who did not develop AKI during an initial 10-day window. The outcome of interest was in-hospital AKI. The exposures of interest were [K+] fluctuations and hypo (HoK) and hyperkalemia (HerK). [K+] variability was evaluated using the coefficient of variation (CV). Cox proportional hazards regression models were used to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) of the association between the exposures of interest and development of AKI. Results: 21,830 hospital admissions from 18,836 patients were included in our study. During a median follow-up of 5 (interquartile range [IQR] 7) days, AKI was observed in 555 hospital admissions (2.9%); median time for AKI development was 5 (IQR 7) days. Higher [K+] variability was independently associated with increased risk of AKI with a statistically significant linear trend across groups (p-value = 0.012). A significantly higher incidence of AKI was documented in patients with HerK compared with normokalemia. No statistically significant difference was observed between HoK and HerK (p-value = 0.92). Conclusion: [K+] abnormalities including fluctuations even within the normal range are associated with development of AKI.

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Seasonality of acute kidney injury in a tertiary hospital academic center: an observational cohort study

Cited by 10 publications

References 21 publications

Seasonal pattern in elderly hospitalized with acute kidney injury: a retrospective nationwide study in Italy

Seasonal pattern in elderly hospitalized with acute kidney injury: a retrospective nationwide study in Italy

Acute Kidney Injury In Turkey: Epidemiological Characteristics, Etiology, Clinical Course And Prognosis

Serum Potassium Disorders Predict Subsequent Kidney Injury: A Retrospective Observational Cohort Study of Hospitalized Patients

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