Long-Term Outcomes After Acute Kidney Injury During Hospitalization: A Systematic Review and Meta-Analysis of Matched...

Area of Science:

• Nephrology
• Critical Care Medicine
• Epidemiology

Background:

• The long-term consequences of acute kidney injury (AKI) among hospital survivors remain a subject of debate.
• Understanding these outcomes is crucial for patient management and prognosis.

Purpose of the Study:

• To systematically review and meta-analyze existing studies on the long-term outcomes of hospital survivors with AKI.
• To compare mortality, need for dialysis, and development of chronic kidney disease (CKD) in AKI survivors versus control populations.

Main Methods:

• A systematic review and meta-analysis of original studies comparing long-term outcomes in hospitalized patients with and without AKI.
• Inclusion criteria: peer-reviewed studies, defined AKI episode, control group, at least one long-term outcome (mortality, dialysis, CKD), and minimum 1-year follow-up.
• Data extraction by two independent investigators, with discrepancies resolved by consensus.

Main Results:

• 14 studies involving 1,058,109 patients with a median follow-up of 3 years were analyzed.
• AKI survivors had significantly increased long-term mortality (26.4% vs. 17.6%; RR, 1.42; p = 0.002).
• AKI survivors also showed a higher risk of requiring dialysis (4.5% vs. 2.0%; RR, 2.48; p < 0.001) and developing CKD (51.5% vs. 37.3%; RR, 1.71; p < 0.001).

Conclusions:

• Hospital survivors of acute kidney injury (AKI) experience a significantly elevated risk of adverse long-term outcomes.
• These risks include increased mortality, a greater likelihood of requiring dialysis, and a higher incidence of developing chronic kidney disease (CKD).