title: Epidemiology and outcome of community-acquired acute kidney injury.
abstract: OBJECTIVE
  Very little data exist regarding community-acquired acute renal injury (CA-AKI). We have identified and characterized a patient cohort with CA-AKI, and documented its impact on renal function and patient mortality.
  
  
  METHODS
  Using the database of the Medical Biochemistry Department of the Cardiff and Vale University Health Board we identified all patients with CA-AKI over a 1 month period in 2009. Follow-up biochemical and clinical data were used to determine short-term (3 months) and long-term (3 years) outcomes. Comparisons were made to a random and an age/sex matched group.
  
  
  RESULTS
  Patients with CA-AKI were older than a non-AKI cohort (70.3 vs 57.1 years; P < 0.0001), with a 61% male predominance. 38% had pre-existing chronic kidney disease (CKD) compared with 25% in the age- and sex-matched non-CA-AKI cohort (P = 0.007). 54% of CA-AKI were admitted for inpatient care. Admission was associated with a higher incidence of complete recovery of renal function. Mortality at 3 months was 16.5%, and was related to the severity of AKI. Over the 3 years of follow-up 71% of patients with CA-AKI developed progressive CKD which was more likely following incomplete/no recovery of renal function and in the context of pre-existing CKD. Three year mortality was 45%, which was higher than that of the age/sex matched control cohort (15.7%; P < 0.0001), but was not related to the development of progressive CKD.
  
  
  CONCLUSIONS
  CA-AKI carries significant implications in terms of both development of progressive renal disease and high long-term patient mortality.
authors.affiliation: Insititute of Nephrology, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Bnar
authors.initials: B
authors.lastname: Talabani
authors.forename: Soha
authors.initials: S
authors.lastname: Zouwail
authors.forename: Rhodri D
authors.initials: RD
authors.lastname: Pyart
authors.forename: Soma
authors.initials: S
authors.lastname: Meran
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Riley
authors.forename: Aled O
authors.initials: AO
authors.lastname: Phillips
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006760:Hospitalization; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014852:Wales / Q000453:epidemiology
keywords: acute renal failure; clinical epidemiology; clinical nephrology; epidemiology