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The risk of chronic kidney disease and mortality are increased after community-acquired acute kidney injury.

dc.contributor.authorSoto, K
dc.contributor.authorCampos, P
dc.contributor.authorPinto, I
dc.contributor.authorRodrigues, B
dc.contributor.authorFrade, F
dc.contributor.authorPapoila, AL
dc.contributor.authorDevarajan, P
dc.date.accessioned2017-05-29T16:28:46Z
dc.date.available2017-05-29T16:28:46Z
dc.date.issued2016
dc.description.abstractWe investigated whether community-acquired acute kidney injury encountered in a tertiary hospital emergency department setting increases the risk of chronic kidney disease (CKD) and mortality, and whether plasma biomarkers could improve the prediction of those adverse outcomes. In a prospective cohort study, we enrolled 616 patients at admission to the emergency department and followed them for a median of 62.1 months. Within this cohort, 130 patients were adjudicated as having acute kidney injury, 159 transient azotemia, 15 stable CKD, and 312 normal renal function. Serum cystatin C and plasma neutrophil gelatinase-associated lipocalin (NGAL) were measured at index admission. After adjusting for clinical variables, the risk of developing CKD stage 3, as well as the risk of death, were increased in the acute kidney injury group (hazard ratio [HR], 5.7 [95% confidence interval, 3.8-8.7] and HR, 1.9 [95% confidence interval, 1.3-2.8], respectively). The addition of serum cystatin C increased the ability to predict the risk of developing CKD stage 3, and death (HR, 1.5 [1.1-2.0] and 1.6 [1.1-2.3], respectively). The addition of plasma NGAL resulted in no improvement in predicting CKD stage 3 or mortality (HR, 1.0 [0.7-1.5] and 1.2 [0.8-1.8], respectively). The risk of developing CKD stage 3 was also significantly increased in the transient azotemia group (HR, 2.4 [1.5-3.6]). Thus, an episode of community acquired acute kidney injury markedly increases the risk of CKD, and moderately increases the risk of death. Our findings highlight the importance of follow-up of patients with community acquired acute kidney injury, for potential early initiation of renal protective strategies.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationKidney Int. 2016 Nov;90(5):1090-1099pt_PT
dc.identifier.doi10.1016/j.kint.2016.07.018pt_PT
dc.identifier.issn1523-1755
dc.identifier.urihttp://hdl.handle.net/10400.10/1864
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectAcute kidney injurypt_PT
dc.subjectBiomarkerspt_PT
dc.subjectLesão aguda do rimpt_PT
dc.subjectBiomarcadorespt_PT
dc.titleThe risk of chronic kidney disease and mortality are increased after community-acquired acute kidney injury.pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceNew Yorkpt_PT
oaire.citation.endPage1099pt_PT
oaire.citation.startPage1090pt_PT
oaire.citation.titleKidney Internationalpt_PT
oaire.citation.volume90pt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT

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