title: Hospital Admission following Acute Kidney Injury in Kidney Transplant Recipients Is Associated with a Negative Impact on Graft Function after 1-Year.
abstract: The incidence and outcomes of acute kidney injury (AKI) in kidney transplantation are poorly known. Retrospective cohort analysis was performed on the data of all patients (≥3 months after transplantation and ≥16 years of age) admitted to the hospital due to medical or surgical complications from 2007 to 2010. We analyzed 458 kidney transplant recipients, 55.2% men, median age 49 (IQR, 36-58) years, median of 12.5 (IQR, 3-35) months after kidney transplantation; admitted to the hospital due to medical or surgical complications. Most of the patients received a kidney from a deceased donor (62.2%), the primary cause for hospital admission was infection (60.7%) and 57 (12.4%) individuals were diagnosed with acute rejection (AR). The incidence of AKI was 82.3%: 31.9% stage 1, 29.3% stage 2 and 21.2% stage 3. Intensive care unit (ICU) admission (OR 8.90, 95% CI: 1.77-44.56 p = 0.008), infection (OR 5.73, 95% CI: 2.61-12.56, p<0.001) and the use of contrast media (OR 9.34, 95% CI: 2.04-42.70, p = 0.004) were the independent risk factors for AKI development. The mortality rate was 2.1% and all patients who died were diagnosed with AKI. Even after the exclusion of AR cases, at the end of 12 months, the individuals with AKI exhibited higher percent changes in creatinine values when compared with individuals without AKI (9.1% vs. -4.3%; p<0.001). According to KDIGO system, we found a high incidence of AKI among the complications of renal transplantation. As in other scenarios, AKI was associated with renal function loss at 1-year after the hospital discharge.
authors.affiliation: Kidney Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil; Nephrology Division, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Thiago Corsi
authors.initials: TC
authors.lastname: Filiponi
authors.affiliation: Kidney Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: Lúcio Roberto
authors.initials: LR
authors.lastname: Requião-Moura
authors.affiliation: Kidney Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: Eduardo José
authors.initials: EJ
authors.lastname: Tonato
authors.affiliation: Kidney Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Carvalho de Matos
authors.affiliation: Kidney Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil; Nephrology Division, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Alvaro Pacheco
authors.initials: AP
authors.lastname: E Silva-Filho
authors.affiliation: Kidney Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil; Nephrology Division, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Marcelino
authors.initials: M
authors.lastname: de Souza Durão Junior
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D006085:Graft Survival; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D066027:Transplant Recipients / Q000706:statistics & numerical data*