Acute kidney injury increases risk of ESRD among elderly

Areef Ishani, Jay L. Xue, Jonathan Himmelfarb, Paul W. Eggers, Paul L. Kimmel, Bruce Molitoris, Allan J. Collins

Research output: Contribution to journalArticle

689 Citations (Scopus)

Abstract

Risk for ESRD among elderly patients with acute kidney injury (AKI) has not been studied in a large, representative sample. This study aimed to determine incidence rates and hazard ratios for developing ESRD in elderly individuals, with and without chronic kidney disease (CKD), who had AKI. In the 2000 5% random sample of Medicare beneficiaries, clinical conditions were identified using Medicare claims; ESRD treatment information was obtained from ESRD registration during 2 yr of follow-up. Our cohort of 233,803 patients were hospitalized in 2000, were aged ≥67 yr on discharge, did not have previous ESRD or AKI, and were Medicare-entitled for ≥2 yr before discharge. In this cohort, 3.1% survived to discharge with a diagnosis of AKI, and 5.3 per 1000 developed ESRD. Among patients who received treatment for ESRD, 25.2% had a previous history of AKI. After adjustment for age, gender, race, diabetes, and hypertension, the hazard ratio for developing ESRD was 41.2 (95% confidence interval [CI] 34.6 to 49.1) for patients with AKI and CKD relative to those without kidney disease, 13.0 (95% CI 10.6 to 16.0) for patients with AKI and without previous CKD, and 8.4 (95% CI 7.4 to 9.6) for patients with CKD and without AKI. In summary, elderly individuals with AKI, particularly those with previously diagnosed CKD, are at significantly increased risk for ESRD, suggesting that episodes of AKI may accelerate progression of renal disease.

Original languageEnglish
Pages (from-to)223-228
Number of pages6
JournalJournal of the American Society of Nephrology
Volume20
Issue number1
DOIs
StatePublished - Jan 2009

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Acute Kidney Injury
Chronic Kidney Failure
Chronic Renal Insufficiency
Medicare
Confidence Intervals
Kidney Diseases
Disease Progression
Hypertension
Kidney
Incidence
Therapeutics

ASJC Scopus subject areas

  • Nephrology

Cite this

Ishani, A., Xue, J. L., Himmelfarb, J., Eggers, P. W., Kimmel, P. L., Molitoris, B., & Collins, A. J. (2009). Acute kidney injury increases risk of ESRD among elderly. Journal of the American Society of Nephrology, 20(1), 223-228. https://doi.org/10.1681/ASN.2007080837

Acute kidney injury increases risk of ESRD among elderly. / Ishani, Areef; Xue, Jay L.; Himmelfarb, Jonathan; Eggers, Paul W.; Kimmel, Paul L.; Molitoris, Bruce; Collins, Allan J.

In: Journal of the American Society of Nephrology, Vol. 20, No. 1, 01.2009, p. 223-228.

Research output: Contribution to journalArticle

Ishani, A, Xue, JL, Himmelfarb, J, Eggers, PW, Kimmel, PL, Molitoris, B & Collins, AJ 2009, 'Acute kidney injury increases risk of ESRD among elderly', Journal of the American Society of Nephrology, vol. 20, no. 1, pp. 223-228. https://doi.org/10.1681/ASN.2007080837
Ishani, Areef ; Xue, Jay L. ; Himmelfarb, Jonathan ; Eggers, Paul W. ; Kimmel, Paul L. ; Molitoris, Bruce ; Collins, Allan J. / Acute kidney injury increases risk of ESRD among elderly. In: Journal of the American Society of Nephrology. 2009 ; Vol. 20, No. 1. pp. 223-228.
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