Long-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study

Abstract The long-term trajectory of kidney function recovery or decline for survivors of critical illness is incompletely understood. Characterising changes in kidney function after critical illness and associated episodes of acute kidney injury (AKI), could inform strategies to monitor and treat n...

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Autores principales:	Ryan W. Haines, Jonah Powell-Tuck, Hugh Leonard, Siobhan Crichton, Marlies Ostermann
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fd96361c7471414d98235411eeb2ff20
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spelling	oai:doaj.org-article:fd96361c7471414d98235411eeb2ff202021-12-02T16:57:37ZLong-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study10.1038/s41598-021-89454-32045-2322https://doaj.org/article/fd96361c7471414d98235411eeb2ff202021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89454-3https://doaj.org/toc/2045-2322Abstract The long-term trajectory of kidney function recovery or decline for survivors of critical illness is incompletely understood. Characterising changes in kidney function after critical illness and associated episodes of acute kidney injury (AKI), could inform strategies to monitor and treat new or progressive chronic kidney disease. We assessed changes in estimated glomerular filtration rate (eGFR) and impact of AKI for 1301 critical care survivors with 5291 eGFR measurements (median 3 [IQR 2, 5] per patient) between hospital discharge (2004–2008) and end of 7 years of follow-up. Linear mixed effects models showed initial decline in eGFR over the first 6 months was greatest in patients without AKI (− 9.5%, 95% CI − 11.5% to − 7.4%) and with mild AKI (− 12.3%, CI − 15.1% to − 9.4%) and least in patients with moderate-severe AKI (− 4.3%, CI − 7.0% to − 1.4%). However, compared to patients without AKI, hospital discharge eGFR was lowest for the moderate-severe AKI group (median 61 [37, 96] vs 101 [78, 120] ml/min/1.73m2) and two thirds (66.5%, CI 59.8–72.6% vs 9.2%, CI 6.8–12.4%) had an eGFR of < 60 ml/min/1.73m2 through to 7 years after discharge. Kidney function trajectory after critical care discharge follows a distinctive pattern of initial drop then sustained decline. Regardless of AKI severity, this evidence suggests follow-up should incorporate monitoring of eGFR in the early months after hospital discharge.Ryan W. HainesJonah Powell-TuckHugh LeonardSiobhan CrichtonMarlies OstermannNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ryan W. Haines Jonah Powell-Tuck Hugh Leonard Siobhan Crichton Marlies Ostermann Long-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study
description	Abstract The long-term trajectory of kidney function recovery or decline for survivors of critical illness is incompletely understood. Characterising changes in kidney function after critical illness and associated episodes of acute kidney injury (AKI), could inform strategies to monitor and treat new or progressive chronic kidney disease. We assessed changes in estimated glomerular filtration rate (eGFR) and impact of AKI for 1301 critical care survivors with 5291 eGFR measurements (median 3 [IQR 2, 5] per patient) between hospital discharge (2004–2008) and end of 7 years of follow-up. Linear mixed effects models showed initial decline in eGFR over the first 6 months was greatest in patients without AKI (− 9.5%, 95% CI − 11.5% to − 7.4%) and with mild AKI (− 12.3%, CI − 15.1% to − 9.4%) and least in patients with moderate-severe AKI (− 4.3%, CI − 7.0% to − 1.4%). However, compared to patients without AKI, hospital discharge eGFR was lowest for the moderate-severe AKI group (median 61 [37, 96] vs 101 [78, 120] ml/min/1.73m2) and two thirds (66.5%, CI 59.8–72.6% vs 9.2%, CI 6.8–12.4%) had an eGFR of < 60 ml/min/1.73m2 through to 7 years after discharge. Kidney function trajectory after critical care discharge follows a distinctive pattern of initial drop then sustained decline. Regardless of AKI severity, this evidence suggests follow-up should incorporate monitoring of eGFR in the early months after hospital discharge.
format	article
author	Ryan W. Haines Jonah Powell-Tuck Hugh Leonard Siobhan Crichton Marlies Ostermann
author_facet	Ryan W. Haines Jonah Powell-Tuck Hugh Leonard Siobhan Crichton Marlies Ostermann
author_sort	Ryan W. Haines
title	Long-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study
title_short	Long-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study
title_full	Long-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study
title_fullStr	Long-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study
title_full_unstemmed	Long-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study
title_sort	long-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/fd96361c7471414d98235411eeb2ff20
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Long-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study

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