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New insights into acute-on-chronic kidney disease in nephrology patients: the CKD-REIN study

dc.rights.licenseopenen_US
dc.contributor.authorHAMROUN, Aghilès
dc.contributor.authorFRIMAT, Luc
dc.contributor.authorLAVILLE, Maurice
dc.contributor.authorMETZGER, Marie
hal.structure.identifierBioingénierie tissulaire [BIOTIS]
dc.contributor.authorCOMBE, Christian
dc.contributor.authorFOUQUE, Denis
dc.contributor.authorJACQUELINET, Christian
dc.contributor.authorAYAV, Carole
dc.contributor.authorLIABEUF, Sophie
dc.contributor.authorLANGE, Céline
dc.contributor.authorHERPE, Yves-Edouard
dc.contributor.authorZEE, Jarcy
dc.contributor.authorGLOWACKI, François
dc.contributor.authorMASSY, Ziad A
dc.contributor.authorROBINSON, Bruce
dc.contributor.authorSTENGEL, Bénédicte
dc.contributor.authorCHRONIC KIDNEY DISEASE-RENAL EPIDEMIOLOGY AND INFORMATION NETWORK (CKD-REIN) STUDY GROUP
dc.date.accessioned2023-04-04T13:04:12Z
dc.date.available2023-04-04T13:04:12Z
dc.date.issued2022-09-01
dc.identifier.issn0931-0509en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/172728
dc.description.abstractEnAcute-on-chronic kidney disease (ACKD) is poorly understood and often overlooked. We studied its incidence, circumstances, determinants and outcomes in patients with CKD.We used the Kidney Disease: Improving Global Outcomes criteria to identify all-stage acute kidney injury (AKI) events in 3033 nephrology outpatients with CKD Stages 3–5 participating in the CKD-Renal Epidemiology and Information Network cohort study (2013–20), and cause-specific Cox models to estimate hazard ratios [HRs; 95% confidence intervals (CIs)] of AKI-associated risk factors.At baseline, 22% of the patients [mean age 67 years, 65% men, mean estimated glomerular filtration rate (eGFR) 32 mL/min/1.73 m2] had a history of AKI. Over a 3-year follow-up, 443 had at least one AKI event: 27% were Stage 2 or 3 and 11% required dialysis; 74% involved hospitalization including 47% acquired as hospital inpatients; and a third were not reported in hospital discharge reports. Incidence rates were 10.1 and 4.8/100 person-years in patients with and without an AKI history, respectively. In 2375 patients without this history, male sex, diabetes, cardiovascular disease, cirrhosis, several drugs, low eGFR and serum albumin levels were significantly associated with a higher risk of AKI, as were low birth weight (<2500 g) (adjusted HR 1.98; 95% CI 1.35–2.91) and haemoglobin level (HR 1.21; 1.12–1.32 per 1 g/dL decrease). Within 1 year, only 63% of the patients had recovered their previous kidney function, 13.7% had started kidney replacement therapy and 12.7% had died.The study highlights the high rate of hospital-acquired AKI events in patients with CKD, and their underreporting at hospital discharge. It also reveals low birth weight and anaemia as possible new risk factors in CKD patients.
dc.language.isoENen_US
dc.subject.enacute kidney injury
dc.subject.enacute-on-chronic kidney disease
dc.subject.enchronic kidney disease
dc.subject.enkidney failure
dc.subject.enrenal recovery
dc.title.enNew insights into acute-on-chronic kidney disease in nephrology patients: the CKD-REIN study
dc.title.alternativeNephrology Dialysis Transplantationen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/ndt/gfab249en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
bordeaux.journalNephrology Dialysis Transplantationen_US
bordeaux.page1700-1709en_US
bordeaux.volume37en_US
bordeaux.hal.laboratoriesBioingénierie Tissulaire (BioTis) - U1026en_US
bordeaux.issue9en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionCNRSen_US
bordeaux.institutionINSERMen_US
bordeaux.institutionCHU de Bordeauxen_US
bordeaux.institutionInstitut Bergoniéen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Nephrology%20Dialysis%20Transplantation&rft.date=2022-09-01&rft.volume=37&rft.issue=9&rft.spage=1700-1709&rft.epage=1700-1709&rft.eissn=0931-0509&rft.issn=0931-0509&rft.au=HAMROUN,%20Aghil%C3%A8s&FRIMAT,%20Luc&LAVILLE,%20Maurice&METZGER,%20Marie&COMBE,%20Christian&rft.genre=article


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