Prognostic indicators of adverse renal outcome and death in acute kidney injury hospital survivors

Introduction: data regarding prognostic factors of post-discharge mortality and adverse renal function outcome in acute kidney injury (aki) hospital survivors are scarce and controversial.objectives: we aimed to identify predictors of post-discharge mortality and adverse renal function outcome in aki hospital survivors.patients and methods: the study group consisted of 84 aki hospital survivors admitted to the tertiary medical center during 2-year period. baseline clinical parameters, with renal outcome 3 months after discharge and 6-month mortality were evaluated. according survival and renal function outcome, patients were divided into two groups.results: patients who did not recover renal function were statistically significantly older (p < 0.007) with higher charlson comorbidity index (cci) score (p < 0.000) and more likely to have anuria and oliguria (p = 0.008) compared to those with recovery. deceased aki patients were statistically significantly older (p < 0.000), with higher cci score (p < 0.000), greater prevalence of sepsis (p =0.004), higher levels of c-reactive protein (crp) (p < 0.017) and ferritin (p < 0.051) and lower concentrations of albumin (p<0.01) compared to survivors. by multivariate analysis, independent predictors of adverse renal outcome were female gender (p =0.033), increasing cci (p =0.000), presence of pre-existing chronic kidney disease (p =0.000) and diabetes mellitus (p =0.019) as well as acute decompensated heart failure (adhf) (p =0.032), while protective factor for renal function outcome was higher urine output (p =0.009). independent predictors of post-discharge mortality were female gender (p =0.04), higher cci score (p =0.001) and sepsis (p =0.034).conclusion: female aki hospital survivors with increasing burden of comorbidities, diagnosis of sepsis and adhf seem to be at high-risk for poor post-discharge outcome.