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Long-Term Kidney Outcomes Following Dialysis-Treated Childhood Acute Kidney Injury: A Population-Based Cohort Study.
- Source :
-
Journal of the American Society of Nephrology : JASN [J Am Soc Nephrol] 2021 Aug; Vol. 32 (8), pp. 2005-2019. Date of Electronic Publication: 2021 May 26. - Publication Year :
- 2021
-
Abstract
- Background: AKI is common during pediatric hospitalizations and associated with adverse short-term outcomes. However, long-term outcomes among survivors of pediatric AKI who received dialysis remain uncertain.<br />Methods: To determine the long-term risk of kidney failure (defined as receipt of chronic dialysis or kidney transplant) or death over a 22-year period for pediatric survivors of dialysis-treated AKI, we used province-wide health administrative databases to perform a retrospective cohort study of all neonates and children (aged 0-18 years) hospitalized in Ontario, Canada, from April 1, 1996, to March 31, 2017, who survived a dialysis-treated AKI episode. Each AKI survivor was matched to four hospitalized pediatric comparators without dialysis-treated AKI, on the basis of age, sex, and admission year. We reported the incidence of each outcome and performed Cox proportional hazards regression analyses, adjusting for relevant covariates.<br />Results: We identified 1688 pediatric dialysis-treated AKI survivors (median age 5 years) and 6752 matched comparators. Among AKI survivors, 53.7% underwent mechanical ventilation and 33.6% had cardiac surgery. During a median 9.6-year follow-up, AKI survivors were at significantly increased risk of a composite outcome of kidney failure or death versus comparators. Death occurred in 113 (6.7%) AKI survivors, 44 (2.6%) developed kidney failure, 174 (12.1%) developed hypertension, 213 (13.1%) developed CKD, and 237 (14.0%) had subsequent AKI. AKI survivors had significantly higher risks of developing CKD and hypertension versus comparators. Risks were greatest in the first year after discharge and gradually decreased over time.<br />Conclusions: Survivors of pediatric dialysis-treated AKI are at higher long-term risks of kidney failure, death, CKD, and hypertension, compared with a matched hospitalized cohort.<br /> (Copyright © 2021 by the American Society of Nephrology.)
- Subjects :
- Adolescent
Case-Control Studies
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Hypertension epidemiology
Incidence
Infant
Infant, Newborn
Male
Mortality
Ontario epidemiology
Proportional Hazards Models
Renal Insufficiency, Chronic epidemiology
Retrospective Studies
Risk Factors
Survivors statistics & numerical data
Time Factors
Acute Kidney Injury therapy
Kidney Failure, Chronic epidemiology
Renal Dialysis
Subjects
Details
- Language :
- English
- ISSN :
- 1533-3450
- Volume :
- 32
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of the American Society of Nephrology : JASN
- Publication Type :
- Academic Journal
- Accession number :
- 34039667
- Full Text :
- https://doi.org/10.1681/ASN.2020111665