title: Anemia and Long-Term Renal Prognosis in Patients with Post-Renal Acute Kidney Injury of Nonmalignant Cause.
abstract: OBJECTIVE
  The renal prognosis of post-renal acute kidney injury (PoR-AKI) has not been verified so far. The objective of this study was to assess the association of baseline anemia with long-term renal prognosis in patients with PoR-AKI.
  
  
  METHODS
  We performed a multicenter retrospective cohort study. Consecutive adult patients from December 2006 to February 2010, who met the requirements as mentioned in the definition of PoR-AKI, were included. Patients without data on baseline renal function and at 6 months after PoR-AKI were excluded. We set baseline hemoglobin (Hb) level (g/dl) as the main exposure to be tested. The main outcome measure was long-term renal prognosis as determined by the difference between proximate estimated glomerular filtration rate (eGFR) at 6 months after diagnosis of PoR-AKI and baseline eGFR prior to the occurrence of the present PoR-AKI (ΔeGFR after 6 months) using the general linear model.
  
  
  RESULTS
  We included 136 patients with PoR-AKI. The most frequent cause of PoR-AKI was malignancy, accounting for 39.0% (n = 53) of cases. Multivariate analysis adjusted for possible confounders showed that ΔeGFR after 6 months significantly changed by -4.28 ml/min/1.73 m2 for every 1 g/dl lower Hb at diagnosis (95% CI 1.86-6.69, p < 0.01). An additional multivariate analysis that was stratified by the presence or absence of malignancy as the cause of PoR-AKI yielded the same significant result only in the stratum of the nonmalignant cause of PoR-AKI.
  
  
  CONCLUSIONS
  Patients with a nonmalignant cause of PoR-AKI who have baseline anemia may have poor long-term renal prognosis. In these cases, close observation of renal function after renal recovery may be required.
authors.affiliation: Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), St. Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Sasaki
authors.forename: Hiroo
authors.initials: H
authors.lastname: Kawarazaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shima
authors.forename: Toshihide
authors.initials: T
authors.lastname: Naganuma
authors.forename: Yugo
authors.initials: Y
authors.lastname: Shibagaki
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D000368:Aged; D000740:Anemia / Q000097:blood / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006454:Hemoglobins