title: Recovery from AKI and short- and long-term outcomes after lung transplantation.
abstract: OBJECTIVE
  Patients with AKI after lung transplantation are at increased risk for CKD and death. Whether patients who completely recover from AKI have improved long-term outcome compared with patients who do not completely recover remains unknown.
  
  
  METHODS
  This study retrospectively evaluated data on 657 patients who underwent lung transplantation from 1997 to 2009. Outcomes analyzed were the incidence of renal recovery after AKI and the association of this recovery with short- and long-term mortality. AKI was defined by an absolute increase in serum creatinine of ≥0.3 mg/dl or a percent increase in serum creatinine of ≥50% from baseline at any time during the first 2 weeks after transplantation.
  
  
  RESULTS
  Four hundred twenty-four (65%) patients experienced AKI in the first 2 weeks after transplantation. Of these patients, complete renal recovery occurred in 142 (33%) patients. The incidence of in-hospital complications was similar between patients who recovered renal function and patients without recovery. At 1 year, the cumulative incidence of CKD was 14% and 22% (P=0.10) and patient survival rate was 81% and 76% (P=0.20) in patients with complete recovery from AKI and patients without recovery, respectively. Patients with completely recovered AKI had similar risk-adjusted long-term mortality compared with patients who did not recover (hazard ratio [95% confidence interval]=1.42 [1.15-2.05] versus 1.53 [1.01-2.00]).
  
  
  CONCLUSIONS
  Patients who recover completely from early AKI after lung transplantation have a similar risk for CKD and long-term mortality compared with patients who do not recover.
authors.affiliation: Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. wehbee@ccf.org
authors.forename: Edgard
authors.initials: E
authors.lastname: Wehbe
authors.forename: Andra E
authors.initials: AE
authors.lastname: Duncan
authors.forename: Gohar
authors.initials: G
authors.lastname: Dar
authors.forename: Marie
authors.initials: M
authors.lastname: Budev
authors.forename: Brian
authors.initials: B
authors.lastname: Stephany
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000581:Amidohydrolases / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000401:mortality*; D020127:Recovery of Function; D051436:Renal Insufficiency, Chronic / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000581:Amidohydrolases; C019946:creatininase