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Characteristics and Outcomes in Community-Acquired Versus Hospital-Acquired Acute Kidney Injury.
MedLine Citation:
PMID:  23336108     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Relatively little is known about the prevalence of acute kidney injury developing outside a hospital setting (CA-AKI) or the impact of CA-AKI on short-term or long-term clinical outcomes. The objective of this study was to compare the prevalence, causes, severity, and outcomes of patients with CA-AKI and hospital acquired (HA)-AKI. METHODS: A retrospective cohort study of patients with AKI identified by ICD-9 code at a single VA hospital from September 1999 to May 2007 was performed. AKI was verified by applying the RIFLE criteria, and patients were categorized as CA-AKI if RIFLE criteria were met at admission. Demographic, clinical, and outcome variables were extracted by chart review. RESULTS: Four hundred twenty two patients met inclusion criteria, of which 335 (79.4%) developed CA-AKI. Patients with CA-AKI were more likely to have volume depletion as the etiology, had fewer chronic illnesses and hospital complications, had a shorter length of stay, and had a reduced mortality, compared to HA-AKI. Distribution among the three RIFLE classes did not differ between groups, and recovery of renal function was incomplete in both groups. CONCLUSIONS: We conclude that CA-AKI is a common cause of AKI that is as severe as that seen in HA-AKI. CA-AKI has a significant impact on length of hospital stay, mortality, and the development and/or progression of chronic kidney disease. Strategies to limit the risk of CA-AKI are likely to have a significant impact on health-care costs and patient care.
Authors:
Michael M Schissler; Syed Zaidi; Haresh Kumar; Datinder Deo; Michael E Brier; Kenneth R McLeish
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-22
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1797     ISO Abbreviation:  Nephrology (Carlton)     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 The Authors. Nephrology © 2013 Asian Pacific Society of Nephrology.
Affiliation:
Department of Medicine, University of Louisville School of Medicine, Louisville, KY.
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