Disparate outcomes observed within Kidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury stage 1 (2023)

Sparrow, H. G., Swan, J. T., Moore, L. W., Gaber, A. O. (2019). Disparate outcomes observed within Kidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury stage 1. Kidney international, 95(4), 905-913. https://doi.org/10.1016/j.kint.2018.11.030

Disparate outcomes observed within Kidney Disease : Improving Global Outcomes (KDIGO) acute kidney injury stage 1. / Sparrow, Harlan G.; Swan, Joshua T.; Moore, Linda W. et al.

In: Kidney international, Vol. 95, No. 4, 04.2019, p. 905-913.

Research output: Contribution to journal › Article › peer-review

Sparrow, HG, Swan, JT, Moore, LW, Gaber, AO 2019, 'Disparate outcomes observed within Kidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury stage 1', Kidney international, vol. 95, no. 4, pp. 905-913. https://doi.org/10.1016/j.kint.2018.11.030

Sparrow HG, Swan JT, Moore LW, Gaber AO, Suki WN. Disparate outcomes observed within Kidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury stage 1. Kidney international. 2019 Apr;95(4):905-913. https://doi.org/10.1016/j.kint.2018.11.030

Sparrow, Harlan G. ; Swan, Joshua T. ; Moore, Linda W. et al. / Disparate outcomes observed within Kidney Disease : Improving Global Outcomes (KDIGO) acute kidney injury stage 1. In: Kidney international. 2019 ; Vol. 95, No. 4. pp. 905-913.

@article{36708eb86d504628b5d690bc8bcf0f9e,

title = "Disparate outcomes observed within Kidney Disease: Improving Global Outcomes (KDIGO) acute kidney injury stage 1",

abstract = "The 2012 Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline classifies acute kidney injury (AKI) into 3 stages defined by serum creatinine elevation or urine output decline. We evaluated the potential impact of further categorizing AKI stage 1 into two stages based on serum creatinine criteria, with a focus on how the resulting 4-stage classification would affect the association of AKI stages with clinical outcomes. We defined AKI stage 1a as an absolute increase in serum creatinine of 0.3 mg/dl within 48 hours and stage 1b as a 50% relative increase in serum creatinine within 7 days. We screened all admissions to 5 hospitals from 2012 to 2014 using standardized inclusion and exclusion criteria and included 81,651 admissions in this retrospective cohort study. The incidence of in-hospital AKI was 7.5% for stage 1a, 4.9% for stage 1b, 1.5% for stage 2, and 0.9% for stage 3. Length of stay following the first incidence of AKI was 3.9 days for stage 1a, 6.2 days for stage 1b, 8.8 days for stage 2, and 12.0 days for stage 3. Compared to patients with no AKI, the odds of in-hospital mortality were progressively higher for patients with higher AKI stages (odds ratio 4.3 for patients with stage 1a, 10.9 for stage 1b, 40.6 for stage 2, and 60.0 for stage 3 AKI). Patients with AKI stages 1a and 1b experienced clinically meaningful and statistically significant differences in length of stay and mortality. This study suggests that a modified 4-stage version of the KDIGO AKI classification may provide additional prognostic information.",

keywords = "acute kidney injury, clinical epidemiology, hospital mortality, length of stay, serum creatinine",

author = "Sparrow, {Harlan G.} and Swan, {Joshua T.} and Moore, {Linda W.} and Gaber, {A. Osama} and Suki, {Wadi N.}",

note = "Publisher Copyright: {\textcopyright} 2019 International Society of Nephrology Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2019",

month = apr,

doi = "10.1016/j.kint.2018.11.030",

language = "English (US)",

volume = "95",

pages = "905--913",

journal = "Kidney international",

issn = "0085-2538",

publisher = "Nature Publishing Group",

number = "4",

}

TY - JOUR

T1 - Disparate outcomes observed within Kidney Disease

T2 - Improving Global Outcomes (KDIGO) acute kidney injury stage 1

AU - Sparrow, Harlan G.

AU - Swan, Joshua T.

AU - Moore, Linda W.

AU - Gaber, A. Osama

AU - Suki, Wadi N.

N1 - Publisher Copyright:© 2019 International Society of NephrologyCopyright:Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2019/4

Y1 - 2019/4

N2 - The 2012 Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline classifies acute kidney injury (AKI) into 3 stages defined by serum creatinine elevation or urine output decline. We evaluated the potential impact of further categorizing AKI stage 1 into two stages based on serum creatinine criteria, with a focus on how the resulting 4-stage classification would affect the association of AKI stages with clinical outcomes. We defined AKI stage 1a as an absolute increase in serum creatinine of 0.3 mg/dl within 48 hours and stage 1b as a 50% relative increase in serum creatinine within 7 days. We screened all admissions to 5 hospitals from 2012 to 2014 using standardized inclusion and exclusion criteria and included 81,651 admissions in this retrospective cohort study. The incidence of in-hospital AKI was 7.5% for stage 1a, 4.9% for stage 1b, 1.5% for stage 2, and 0.9% for stage 3. Length of stay following the first incidence of AKI was 3.9 days for stage 1a, 6.2 days for stage 1b, 8.8 days for stage 2, and 12.0 days for stage 3. Compared to patients with no AKI, the odds of in-hospital mortality were progressively higher for patients with higher AKI stages (odds ratio 4.3 for patients with stage 1a, 10.9 for stage 1b, 40.6 for stage 2, and 60.0 for stage 3 AKI). Patients with AKI stages 1a and 1b experienced clinically meaningful and statistically significant differences in length of stay and mortality. This study suggests that a modified 4-stage version of the KDIGO AKI classification may provide additional prognostic information.

AB - The 2012 Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline classifies acute kidney injury (AKI) into 3 stages defined by serum creatinine elevation or urine output decline. We evaluated the potential impact of further categorizing AKI stage 1 into two stages based on serum creatinine criteria, with a focus on how the resulting 4-stage classification would affect the association of AKI stages with clinical outcomes. We defined AKI stage 1a as an absolute increase in serum creatinine of 0.3 mg/dl within 48 hours and stage 1b as a 50% relative increase in serum creatinine within 7 days. We screened all admissions to 5 hospitals from 2012 to 2014 using standardized inclusion and exclusion criteria and included 81,651 admissions in this retrospective cohort study. The incidence of in-hospital AKI was 7.5% for stage 1a, 4.9% for stage 1b, 1.5% for stage 2, and 0.9% for stage 3. Length of stay following the first incidence of AKI was 3.9 days for stage 1a, 6.2 days for stage 1b, 8.8 days for stage 2, and 12.0 days for stage 3. Compared to patients with no AKI, the odds of in-hospital mortality were progressively higher for patients with higher AKI stages (odds ratio 4.3 for patients with stage 1a, 10.9 for stage 1b, 40.6 for stage 2, and 60.0 for stage 3 AKI). Patients with AKI stages 1a and 1b experienced clinically meaningful and statistically significant differences in length of stay and mortality. This study suggests that a modified 4-stage version of the KDIGO AKI classification may provide additional prognostic information.

KW - acute kidney injury

KW - clinical epidemiology

KW - hospital mortality

KW - length of stay

KW - serum creatinine

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U2 - 10.1016/j.kint.2018.11.030

DO - 10.1016/j.kint.2018.11.030

M3 - Article

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VL - 95

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EP - 913

JO - Kidney international

JF - Kidney international

SN - 0085-2538

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