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Acute Kidney Injury Prognosis

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Acute Kidney Injury Prognosis, Acute Renal Failure Prognosis

  • See Also
  1. Acute Kidney Injury
  2. Acute Interstitial Nephritis
  3. Acute Prerenal Failure
  4. Acute Postrenal Failure
  5. Medication Causes of Acute Kidney Injury
  6. Acute Kidney Injury Causes
  7. Nephrotoxicity Risk
  8. Intravenous Contrast Related Acute Renal Failure
  9. Chronic Renal Failure
  10. Prevention of Kidney Disease Progression
  1. Acute Kidney Injury increases the risk for later conditions and complications
    1. Chronic Kidney Disease
    2. End-stage renal disease
    3. Premature death
  1. Serum Creatinine >= 3 mg/dl
    1. Mortality: 64%
  2. Serum Creatinine < 2mg/dl and non-oliguric
    1. Mortality: 5-20%
  • Prognosis
  • Oliguric ATN requiring Dialysis
  1. Mortality: 50%
  2. Worse prognostic factors
    1. Serious comorbid condition
    2. APACHE Score (version 2) <25
      1. Note that APACHE 2 has been replaced by APACHE 4, with new scoring
  • Prognosis
  • Multiple Organ Failure
  1. Mortality: 30% per organ system that fails
  2. Specific organ related risks
    1. Respiratory Failure: 8 fold increased mortality
    2. Liver disease: 2-3 fold increased mortality
    3. Catabolic state: 2 fold increased mortality
    4. Heart disease: 3-4 fold increased mortality
  • Prognosis
  • Non-Prognostic Factors (Factors not related to mortality)
  1. Advanced age
  2. Admission Serum Creatinine
  3. Number of prior episodes of Renal Insufficiency
  • Prevention
  1. See Prevention of Kidney Disease Progression
  • Resources
  1. Acute Kidney Injury Guidelines
    1. http://www.renal.org/clinical/guidelinessection/AcuteKidneyInjury.aspx
  • Reference
  1. Coca (2009) Am J Kidney Dis 53(6): 961-73 [PubMed]
  2. Goldberg (2008) Adv Chronic Kidney Dis 15(3): 297-307 [PubMed]
  3. Meyer (2007) N Engl J Med 357(13): 1316-25 [PubMed]
  4. Rahman (2012) Am Fam Physician 86(7): 631-9 [PubMed]
  5. Singri (2003) JAMA 289(6):747-51 [PubMed]