title: Prognostic indicators of adverse renal outcome and death in acute kidney injury hospital survivors.
abstract: BACKGROUND
  Data regarding prognostic factors of post-discharge mortality and adverse renal function outcome in acute kidney injury (AKI) hospital survivors are scarce and controversial.
  
  
  OBJECTIVE
  We aimed to identify predictors of post-discharge mortality and adverse renal function outcome in AKI hospital survivors.
  
  
  METHODS
  The study group consisted of 84 AKI hospital survivors admitted to the tertiary medical center during 2-year period. Baseline clinical parameters, with renal outcome 3 months after discharge and 6-month mortality were evaluated. According survival and renal function outcome, patients were divided into two groups.
  
  
  RESULTS
  Patients who did not recover renal function were statistically significantly older (P < 0.007) with higher Charlson comorbidity index (CCI) score (P < 0.000) and more likely to have anuria and oliguria (P = 0.008) compared to those with recovery. Deceased AKI patients were statistically significantly older (P < 0.000), with higher CCI score (P < 0.000), greater prevalence of sepsis (P =0.004), higher levels of C-reactive protein (CRP) (P < 0.017) and ferritin (P < 0.051) and lower concentrations of albumin (P<0.01) compared to survivors. By multivariate analysis, independent predictors of adverse renal outcome were female gender (P =0.033), increasing CCI (P =0.000), presence of pre-existing chronic kidney disease (P =0.000) and diabetes mellitus (P =0.019) as well as acute decompensated heart failure (ADHF) (P =0.032), while protective factor for renal function outcome was higher urine output (P =0.009). Independent predictors of post-discharge mortality were female gender (P =0.04), higher CCI score (P =0.001) and sepsis (P =0.034).
  
  
  CONCLUSIONS
  Female AKI hospital survivors with increasing burden of comorbidities, diagnosis of sepsis and ADHF seem to be at high-risk for poor post-discharge outcome.
authors.affiliation: Clinic of Nephrology, University Clinical Center Sarajevo, Bolnička 25, 71 000, Sarajevo, Bosnia and Herzegovina.
authors.forename: Aida
authors.initials: A
authors.lastname: Hamzić-Mehmedbašić
authors.affiliation: Clinic of Nephrology, University Clinical Center Sarajevo, Bolnička 25, 71 000, Sarajevo, Bosnia and Herzegovina.
authors.forename: Senija
authors.initials: S
authors.lastname: Rašić
authors.affiliation: Bournemouth University, Christchurch House C208, Talbot Campus, Fern Barrow, Poole, BH12 5BB, United Kingdom.
authors.forename: Merima
authors.initials: M
authors.lastname: Balavac
authors.affiliation: Clinic of Nephrology, University Clinical Center Sarajevo, Bolnička 25, 71 000, Sarajevo, Bosnia and Herzegovina.
authors.forename: Damir
authors.initials: D
authors.lastname: Rebić
authors.affiliation: Institute of Clinical Immunology, University Clinical Center Sarajevo, Bolnička 25, 71 000, Sarajevo, Bosnia and Herzegovina.
authors.forename: Marina
authors.initials: M
authors.lastname: Delić-Šarac
authors.affiliation: Clinic for Heart Disease and Rheumatism, University Clinical Center Sarajevo, Bolnička 25, 71 000, Sarajevo, Bosnia and Herzegovina.
authors.forename: Azra
authors.initials: A
authors.lastname: Durak-Nalbantić
keywords: Acute kidney injury; Adverse renal outcome; Post-discharge mortality; Prognostic factors