AKI in the very elderly patients without preexisting chronic kidney disease: a comparison of 48-hour window and 7-day window for diagnosing AKI using the KDIGO criteria

Qinglin Li,1 Meng Zhao,2 Xiaodan Wang1 1Department of Health Care, Nanlou Division, Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China; 2Department of Clinical Data Repository, Chinese PLA General Hospital, Beijing, China Objectives: To compare t...

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Autores principales:	Li Q, Zhao M, Wang X
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	acute kidney injury AKI diagnosis time very elderly short-term mortality Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/d06901acd7444e5aaa66e87a73ece235
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spelling	oai:doaj.org-article:d06901acd7444e5aaa66e87a73ece2352021-12-02T00:42:21ZAKI in the very elderly patients without preexisting chronic kidney disease: a comparison of 48-hour window and 7-day window for diagnosing AKI using the KDIGO criteria1178-1998https://doaj.org/article/d06901acd7444e5aaa66e87a73ece2352018-06-01T00:00:00Zhttps://www.dovepress.com/aki-in-the-very-elderly-patients-without-preexisting-chronic-kidney-di-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Qinglin Li,1 Meng Zhao,2 Xiaodan Wang1 1Department of Health Care, Nanlou Division, Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China; 2Department of Clinical Data Repository, Chinese PLA General Hospital, Beijing, China Objectives: To compare the differences between the Kidney Disease Improving Global Outcomes (KDIGO) criteria of the 48-hour window and the 7-day window in the diagnosis of acute kidney injury (AKI) in very elderly patients, as well as the relationship between the 48-hour and 7-day windows for diagnosis and 90-day mortality. Patients and methods: We retrospectively enrolled very elderly patients (≥75 years old) from the geriatrics department of the Chinese PLA General Hospital between January 2007 and December 2015. AKI patients were divided into 48-hour and 7-day groups by their diagnosis criteria. AKI patients were divided into survivor and nonsurvivor groups by their outcomes within 90 days after diagnosis of AKI. Results: In total, 652 patients were included in the final analysis. The median age of the cohort was 87 (84–91) years, the majority (623, 95.6%) of whom were male. Of the 652 AKI patients, 334 cases (51.2%) were diagnosed with AKI by the 48-hour window for diagnosis, while 318 cases (48.8%) were by the 7-day window for diagnosis. The 90-day mortality was 42.5% in patients with 48-hour window AKI and 24.2% in patients with 7-day window AKI. Kaplan–Meier curves showed that 90-day mortality was lower in the 7-day window AKI group than in the 48-hour window AKI group (log rank: P<0.001). Multivariate analysis by the Cox model revealed that 48-hour window for diagnosis hazard ratio (HR=1.818; 95% CI: 1.256–2.631; P=0.002) was associated with higher 90-day mortality. Conclusion: The 90-day mortality was higher in 48-hour window AKI than in 7-day window AKI in very elderly patients. The 48-hour KDIGO window definition may be less sensitive. The 48-hour KDIGO window definition is significantly better correlated with subsequent mortality and is, therefore, still appropriate for clinical use. Finding early, sensitive biomarkers of kidney damage is a future direction of research. Keywords: acute kidney injury, AKI diagnosis time, very elderly, short-term mortalityLi QZhao MWang XDove Medical Pressarticleacute kidney injuryAKI diagnosis timevery elderlyshort-term mortalityGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 1151-1160 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute kidney injury AKI diagnosis time very elderly short-term mortality Geriatrics RC952-954.6
spellingShingle	acute kidney injury AKI diagnosis time very elderly short-term mortality Geriatrics RC952-954.6 Li Q Zhao M Wang X AKI in the very elderly patients without preexisting chronic kidney disease: a comparison of 48-hour window and 7-day window for diagnosing AKI using the KDIGO criteria
description	Qinglin Li,1 Meng Zhao,2 Xiaodan Wang1 1Department of Health Care, Nanlou Division, Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China; 2Department of Clinical Data Repository, Chinese PLA General Hospital, Beijing, China Objectives: To compare the differences between the Kidney Disease Improving Global Outcomes (KDIGO) criteria of the 48-hour window and the 7-day window in the diagnosis of acute kidney injury (AKI) in very elderly patients, as well as the relationship between the 48-hour and 7-day windows for diagnosis and 90-day mortality. Patients and methods: We retrospectively enrolled very elderly patients (≥75 years old) from the geriatrics department of the Chinese PLA General Hospital between January 2007 and December 2015. AKI patients were divided into 48-hour and 7-day groups by their diagnosis criteria. AKI patients were divided into survivor and nonsurvivor groups by their outcomes within 90 days after diagnosis of AKI. Results: In total, 652 patients were included in the final analysis. The median age of the cohort was 87 (84–91) years, the majority (623, 95.6%) of whom were male. Of the 652 AKI patients, 334 cases (51.2%) were diagnosed with AKI by the 48-hour window for diagnosis, while 318 cases (48.8%) were by the 7-day window for diagnosis. The 90-day mortality was 42.5% in patients with 48-hour window AKI and 24.2% in patients with 7-day window AKI. Kaplan–Meier curves showed that 90-day mortality was lower in the 7-day window AKI group than in the 48-hour window AKI group (log rank: P<0.001). Multivariate analysis by the Cox model revealed that 48-hour window for diagnosis hazard ratio (HR=1.818; 95% CI: 1.256–2.631; P=0.002) was associated with higher 90-day mortality. Conclusion: The 90-day mortality was higher in 48-hour window AKI than in 7-day window AKI in very elderly patients. The 48-hour KDIGO window definition may be less sensitive. The 48-hour KDIGO window definition is significantly better correlated with subsequent mortality and is, therefore, still appropriate for clinical use. Finding early, sensitive biomarkers of kidney damage is a future direction of research. Keywords: acute kidney injury, AKI diagnosis time, very elderly, short-term mortality
format	article
author	Li Q Zhao M Wang X
author_facet	Li Q Zhao M Wang X
author_sort	Li Q
title	AKI in the very elderly patients without preexisting chronic kidney disease: a comparison of 48-hour window and 7-day window for diagnosing AKI using the KDIGO criteria
title_short	AKI in the very elderly patients without preexisting chronic kidney disease: a comparison of 48-hour window and 7-day window for diagnosing AKI using the KDIGO criteria
title_full	AKI in the very elderly patients without preexisting chronic kidney disease: a comparison of 48-hour window and 7-day window for diagnosing AKI using the KDIGO criteria
title_fullStr	AKI in the very elderly patients without preexisting chronic kidney disease: a comparison of 48-hour window and 7-day window for diagnosing AKI using the KDIGO criteria
title_full_unstemmed	AKI in the very elderly patients without preexisting chronic kidney disease: a comparison of 48-hour window and 7-day window for diagnosing AKI using the KDIGO criteria
title_sort	aki in the very elderly patients without preexisting chronic kidney disease: a comparison of 48-hour window and 7-day window for diagnosing aki using the kdigo criteria
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/d06901acd7444e5aaa66e87a73ece235
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AKI in the very elderly patients without preexisting chronic kidney disease: a comparison of 48-hour window and 7-day window for diagnosing AKI using the KDIGO criteria

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