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Late evaluate of survival and recovery of renal function of patients after acute kidney injury episodes of different etiologies

Grant number: 13/19453-5
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): December 01, 2013
Effective date (End): November 30, 2014
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal researcher:Daniela Ponce
Grantee:Luana Carolina Poncio de Oliveira
Home Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Acute Kidney Injury (AKI) is common in hospitalized patients and it is characterized by a sudden decrease in renal function, multifactorial and high mortality in-hospital and long-term. Recent data from the literature show that patients with AKI should be followed for long periods, even after the resolution of AKI. When evaluating the late prognosis of AKI, not only survival but also the recovery and progression of kidney disease are important issues. Recent studies show that the survival of these patients after 10 years varies from 15 to 72%. AKI is also associated with the development of chronic kidney disease by mechanisms not yet completely defined. Thus, the results of the long-term outcome of patients after AKI episodes of different etiologies are rare or unknown and many authors believe the AKI should not be seen as an event that is resolved after a few days and that patients should be followed for long periods. Objectives: The aim of our study is to evaluate and compare the survival and recovery of renal function of patients after long-term AKI episodes of different etiologies. Methodology: This is a retrospective cohort study in a single center with patients treated and followed by the Group of AKI, Department of Clinical Medicine, Botucatu Medical School in the period from October 2004 to December 2013. This will include patients who survived the renal and pors renal AKI episode followed by nephrologists for a minimum period of 12 months after hospital discharge. The diagnosis of AKI is based on the AKIN criteria and obtained by clinical history, identification of insult, physical examination, serum and urine data, and renal ultrasound when needed. Patients younger than 18 years, with others etiologies of AKI, with baseline creatinine > 4mg/dl (advanced CKD), renal transplant, and pregnant women will be excluded. Patients will be evaluated for clinical and laboratory characteristics, progression of CKD, and death. Then patients will be divided according to the etiology of AKI and compared regarding clinical features, recovery of renal function, and death being excluded patients with missing follow-up. Initially, a descriptive analysis of all patients enrolled in the period will be performed. After, the patients will be divided into groups according to the etiology of AKI and compared for the different variables using the t-test or Mann -Whitney for continuous variables and Chi-square or Fisher test for categorical variables. At the end of the study, the Kaplan-Meyer survival curve will be presented. For all tests, the significance level will be 5 %. (AU)

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