Community-Acquired Acute Kidney Injury: A Nationwide Survey in China.
Am J Kidney Dis
; 69(5): 647-657, 2017 May.
Article
em En
| MEDLINE
| ID: mdl-28117208
ABSTRACT
BACKGROUND:
This study aimed to describe the burden of community-acquired acute kidney injury (AKI) in China based on a nationwide survey about AKI. STUDYDESIGN:
Cross-sectional and retrospective study. SETTING &PARTICIPANTS:
A national sample of 2,223,230 hospitalized adult patients from 44 academic/local hospitals in Mainland China was used. AKI was defined according to the 2012 KDIGO AKI creatinine criteria or an increase or decrease in serum creatinine level of 50% during the hospital stay. Community-acquired AKI was identified when a patient had AKI that could be defined at hospital admission. PREDICTORS The rate, cause, recognition, and treatment of community-acquired AKI were stratified according to hospital type, latitude, and economic development of the regions in which the patients were admitted.OUTCOMES:
All-cause in-hospital mortality and recovery of kidney function at hospital discharge.RESULTS:
4,136 patients with community-acquired AKI were identified during the 2 single-month snapshots (January 2013 and July 2013). Of these, 2,020 (48.8%) had cases related to decreased kidney perfusion; 1,111 (26.9%), to intrinsic kidney disease; and 499 (12.1%), to urinary tract obstruction. In the north versus the south, more patients were exposed to nephrotoxins or had urinary tract obstructions. 536 (13.0%) patients with community-acquired AKI had indications for renal replacement therapy (RRT), but only 347 (64.7%) of them received RRT. Rates of timely diagnosis and appropriate use of RRT were higher in regions with higher per capita gross domestic product. All-cause in-hospital mortality was 7.3% (295 of 4,068). Delayed AKI recognition and being located in northern China were independent risk factors for in-hospital mortality, and referral to nephrology providers was an independent protective factor.LIMITATIONS:
Possible misclassification of AKI and community-acquired AKI due to nonstandard definitions and missing data for serum creatinine.CONCLUSIONS:
The features of community-acquired AKI varied substantially in different regions of China and were closely linked to the environment, economy, and medical resources.Palavras-chave
Texto completo:
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Temas:
ECOS
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Estado_mercado_regulacao
Bases de dados:
MEDLINE
Assunto principal:
Mortalidade Hospitalar
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Recuperação de Função Fisiológica
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Injúria Renal Aguda
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Am J Kidney Dis
Ano de publicação:
2017
Tipo de documento:
Article