{"id":19919,"date":"2024-07-17T15:48:00","date_gmt":"2024-07-17T19:48:00","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=19919"},"modified":"2024-07-25T15:48:51","modified_gmt":"2024-07-25T19:48:51","slug":"long-term-kidney-outcomes-after-pediatric-acute-kidney-injury","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/long-term-kidney-outcomes-after-pediatric-acute-kidney-injury\/","title":{"rendered":"Long-term kidney outcomes after pediatric acute kidney injury"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Acute kidney injury (AKI) is common in hospitalized children. Pediatric AKI receiving acute kidney replacement therapy (KRT) is associated with long-term chronic kidney disease (CKD), hypertension, and death. We aim to determine the outcomes after AKI in children who did not receive acute KRT, since these remain uncertain.<\/p>\n<p><strong>Methods<\/strong> \u2014 Retrospective cohort study of all hospitalized children (0-18 years) surviving AKI without acute KRT between 1996-2020 in Ontario, Canada, identified by validated diagnostic codes in provincial administrative health databases. Children with prior KRT, CKD, or AKI were excluded. Cases were matched with up to four hospitalized comparators without AKI by age, neonatal status, sex, intensive care unit admission, cardiac surgery, malignancy, hypertension, hospitalization era, and a propensity score for AKI. Patients were followed until death, provincial emigration, or censoring in March 2021. The primary outcome was long-term major adverse kidney events (MAKE-LT; a composite of all-cause mortality, long-term KRT, or incident CKD).<\/p>\n<p><strong>Results<\/strong> \u2014 We matched 4,173 pediatric AKI survivors with 16,337 hospitalized comparators. Baseline covariates were well-balanced following propensity score matching. During median 9.7-year follow-up, 18% of AKI survivors developed MAKE-LT vs. 5% of hospitalized comparators (hazard ratio [HR] 4.0, 95% confidence interval [CI] 3.6-4.4). AKI survivors had higher rates of long-term KRT (2% vs. &lt;1%; HR 11.7, 95%CI 7.5-18.4), incident CKD (16% vs. 2%; HR 7.9, 95%CI 6.9-9.1), incident hypertension (17% vs. 8%; HR 2.3, 95%CI 2.1-2.6), and AKI during subsequent hospitalization (6% vs. 2%; HR 3.7, 95%CI 3.1-4.5), but no difference in all-cause mortality (3% vs. 3%; HR 0.9, 95%CI 0.7-1.1).<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Children surviving AKI without acute KRT were at higher long-term risk of CKD, long-term KRT, hypertension, and subsequent AKI vs. hospitalized comparators.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Acute kidney injury (AKI) is common in hospitalized children. Pediatric AKI receiving acute kidney replacement therapy (KRT) is associated with long-term chronic kidney disease (CKD), hypertension, and death. We aim to determine the outcomes after AKI in children who did not receive acute KRT, since these remain uncertain. Methods \u2014 Retrospective cohort study [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[16,49],"migration-helper-qa-sample-set":[],"class_list":["post-19919","journal_article","type-journal_article","status-publish","hentry","topic-children-and-young-people","topic-kidney-disease"],"acf":{"citation":"Robinson CH, Jeyakumar N, Luo B, Askenazi D, Deep A, Garg AX, Goldstein S, Greenberg JH, Mammen C, Nash DM, Parekh RS, Silver SA, Thabane L, Wald R, Zappitelli M, Chanchlani R.<em> J Am Soc Nephrol<\/em>. 2024; Jul 17 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1681\/asn.0000000000000445","ices_scientist":[1242,1357,1194],"site":[6739],"research_program":[6743],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Long-term kidney outcomes after pediatric acute kidney injury<\/title>\n<meta name=\"description\" content=\"Background \u2014 Acute kidney injury (AKI) is common in hospitalized children. 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