Yonsei Med J.  2022 Oct;63(10):902-907. 10.3349/ymj.2021.0238.

Comparison of Outcomes of Mild and Severe Community- and Hospital-Acquired Acute Kidney Injury

• Medina KRP
• Jeong JC
• Ryu JW
• Kang E
• Chin HJ
• Na KY
• Chae DW
• Kim S

• KMID: 2533382
• DOI: http://doi.org/10.3349/ymj.2021.0238

Abstract

Purpose
Acute kidney injury (AKI) has shown an increasingly common occurrence among hospitalized patients worldwide. We determined the incidence and compared the short- and long-term outcomes of all stages of community-acquired AKI (CA-AKI) and hospital-acquired AKI (HA-AKI), and identified predictors for such outcomes.
Materials and Methods
This observational, single-center, retrospective study identified patients admitted between January 2013 and December 2013 who developed CA-AKI or HA-AKI. Short- and long-term patient and renal outcomes were analyzed.
Results
AKI incidence was 14.3% (1882, CA-AKI 4.8% and HA-AKI 9.5%). The highest 30-day and 1-year mortality were recorded in the CA-AKI group. Thirty-day mortality rate was 11.4% in CA-AKI group and 5.7% in HA-AKI group (p<0.001). One-year mortality rates were 20.1% and 13.3%, respectively (p<0.001). More CA-AKI patients developed kidney failure with replacement therapy within 1 year (27, 4.3% vs. 18, 1.4% respectively, p<0.001).
Conclusion
In conclusion, patients with CA-AKI had worse short- and long-term outcomes compared to HA-AKI patients. AKI severity and discharge serum creatinine were significant independent predictors of 30-day and 1-year mortality.

Keyword

Acute kidney injury; community-acquired; hospital-acquired; mortality; outcomes