title: Long-term outcomes of community-acquired versus hospital-acquired acute kidney injury: a retrospective analysis.
abstract: OBJECTIVE
  To compare long-term outcomes in CA-AKI to HA-AKI. The hypothesis was that renal and patient survival would be better in CA-AKI than in HA-AKI.
  
  
  METHODS
  Retrospective cohort analysis of patients hospitalized from 2004 to 2005, in Upstate New York Veterans Affairs hospitals. The groups: CA-AKI (n = 560), HA-AKI (n = 158), or No AKI (NA) (n = 2,320). Risk, injury, failure, loss, and end-stage kidney (RIFLE) criterion was used to define AKI.
  
  
  METHODS
  doubling of serum creatinine, endstage renal disease (ESRD), death, and a composite of the three.
  
  
  RESULTS
  de novo chronic kidney disease (CKD), recovery of renal function, and re-admission rate. The cumulative incidence of outcomes was determined over a period of 3 years after discharge.
  
  
  RESULTS
  CA-AKI was 3.5 times as prevalent as HA-AKI. In comparison to patients with HA-AKI, those with CA-AKI had better estimated glomerular filtration rate (71.3 vs. 61.1 mL/min/1.73 m(2), p < 0.001) and lower prevalence of CKD (42.3 vs. 51.9%, p = 0.03) at baseline. More patients with CA-AKI than HA-AKI met RIFLE failure criterion (43.8 vs. 29.1%, p < 0.001). By 3 years, no differences were found for the individual primary and secondary outcomes tested (all p > 0.05).
  
  
  CONCLUSIONS
  CA-AKI was found to be considerably more common than HA-AKI and had similar long-term consequences.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Der Mesropian
authors.forename: John S
authors.initials: JS
authors.lastname: Kalamaras
authors.forename: George
authors.initials: G
authors.lastname: Eisele
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Phelps
authors.forename: Arif
authors.initials: A
authors.lastname: Asif
authors.forename: Roy O
authors.initials: RO
authors.lastname: Mathew
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005919:Glomerular Filtration Rate; D006760:Hospitalization; D006787:Hospitals, Veterans; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D016015:Logistic Models; D015999:Multivariate Analysis; D009518:New York; D015995:Prevalence; D016016:Proportional Hazards Models; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003404:Creatinine