Featured Research

from universities, journals, and other organizations

In-hospital Kidney Injury Requiring Dialysis Linked To Risk Of Chronic Dialysis

Date:
September 15, 2009
Source:
JAMA and Archives Journals
Summary:
Hospitalized patients who experience acute kidney problems that require dialysis are at increased risk of receiving chronic dialysis once discharged, but do not have an increased risk of death, according to a new study.

Hospitalized patients who experience acute kidney problems that require dialysis are at increased risk of receiving chronic dialysis once discharged, but do not have an increased risk of death, according to a study in the September 16 issue of JAMA.

Related Articles


"Acute kidney injury, which leads to a sudden decline in kidney function, is a common and serious complication of hospitalization in the adult population. Many patients with severe acute kidney injury require initiation of hemodialysis or hemofiltration [dialysis], and their in-hospital mortality rate ranges from 45 percent to 70 percent. Among those who survive, as many as 15 percent require dialysis at the time of discharge," according to background information in the article. The authors note that little is known about the long-term outcomes of patients with an acute kidney injury that requires in-hospital dialysis, especially once they leave the hospital and recover enough kidney function to be free of dialysis in the short term.

Ron Wald, M.D.C.M., M.P.H., F.R.C.P.C., of St Michael's Hospital, Toronto, and the University of Toronto, and colleagues evaluated the long-term risk of chronic dialysis and death among hospitalized patients in Ontario, Canada, who sustained an acute kidney injury while hospitalized, required dialysis and survived free of dialysis for at least 30 days after discharge. These individuals (n = 3,769) were matched with patients without acute kidney injury or dialysis during their hospitalization (n = 13,598). Patients were followed up until March 2007. The average age of the enrolled participants was 62 years, and approximately 40 percent were women.

After a median (midpoint) follow-up of 3 years, the researchers "found that survivors of a hospitalization complicated by acute kidney injury requiring dialysis were approximately 3 times more likely to require chronic dialysis compared with those without acute kidney injury. However, no difference was observed between these groups for long-term mortality."

"Our findings expand on prior knowledge to provide clinicians with new information about the long-term effect of acute kidney injury that arises during a hospitalization. First, if affected patients survive to hospital discharge, then they remain at high risk of needing dialysis over the next 3 to 5 years. Patients who survive a hospitalization complicated by acute kidney injury requiring dialysis may benefit from specialized care to address complications of chronic kidney disease, and also from concerted efforts to prevent progression to chronic dialysis. At the same time, their high mortality rate is similar to hospitalized patients without acute kidney injury or need for dialysis. Hence, an episode of acute kidney injury requiring in-hospital dialysis may not be an independent contributing factor to long-term survival," the authors conclude.

Editorial: Chronic on Acute Renal Failure -- Long-term Implications of Severe Acute Kidney Injury

In an accompanying editorial, Sushrut S. Waikar, M.D., M.P.H., of Brigham and Women's Hospital and Harvard Medical School, Boston, and Wolfgang C. Winkelmayer, M.D., M.P.H., Sc.D., of Stanford University School of Medicine, Palo Alto, Calif., write on the importance of preventing and treating kidney disease and injury.

"Based on the available evidence from administrative and laboratory-based databases, severe acute kidney injury seems to increase the risk of progressive chronic kidney disease and may increase the risk of death. Given the extraordinarily high rates of morbidity and mortality observed in chronic kidney disease patients and acute kidney injury patients, the complex interconnection between them, and increasing incidence of both, kidney disease prevention and treatment should be a major public health priority."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Ron Wald; Robert R. Quinn; Jin Luo; Ping Li; Damon C. Scales; Muhammad M. Mamdani; Joel G. Ray; for the University of Toronto Acute Kidney Injury Research Group. Chronic Dialysis and Death Among Survivors of Acute Kidney Injury Requiring Dialysis. JAMA, 2009; 302 (11): 1179-1185 [link]
  2. Sushrut S. Waikar; Wolfgang C. Winkelmayer. Chronic on Acute Renal Failure: Long-term Implications of Severe Acute Kidney Injury. JAMA, 2009; 302 (11): 1227-1229 [link]

Cite This Page:

JAMA and Archives Journals. "In-hospital Kidney Injury Requiring Dialysis Linked To Risk Of Chronic Dialysis." ScienceDaily. ScienceDaily, 15 September 2009. <www.sciencedaily.com/releases/2009/09/090915174327.htm>.
JAMA and Archives Journals. (2009, September 15). In-hospital Kidney Injury Requiring Dialysis Linked To Risk Of Chronic Dialysis. ScienceDaily. Retrieved December 22, 2014 from www.sciencedaily.com/releases/2009/09/090915174327.htm
JAMA and Archives Journals. "In-hospital Kidney Injury Requiring Dialysis Linked To Risk Of Chronic Dialysis." ScienceDaily. www.sciencedaily.com/releases/2009/09/090915174327.htm (accessed December 22, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, December 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Christmas Kissing Good for Health

Christmas Kissing Good for Health

Reuters - Innovations Video Online (Dec. 22, 2014) Scientists in Amsterdam say couples transfer tens of millions of microbes when they kiss, encouraging healthy exposure to bacteria. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Brain-Dwelling Tapeworm Reveals Genetic Secrets

Brain-Dwelling Tapeworm Reveals Genetic Secrets

Reuters - Innovations Video Online (Dec. 22, 2014) Cambridge scientists have unravelled the genetic code of a rare tapeworm that lived inside a patient's brain for at least four year. Researchers hope it will present new opportunities to diagnose and treat this invasive parasite. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Touch-Free Smart Phone Empowers Mobility-Impaired

Touch-Free Smart Phone Empowers Mobility-Impaired

Reuters - Innovations Video Online (Dec. 21, 2014) A touch-free phone developed in Israel enables the mobility-impaired to operate smart phones with just a movement of the head. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Earthworms Provide Cancer-Fighting Bacteria

Earthworms Provide Cancer-Fighting Bacteria

Reuters - Innovations Video Online (Dec. 21, 2014) Polish scientists isolate bacteria from earthworm intestines which they say may be used in antibiotics and cancer treatments. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins