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Kidney Int. 2009 Oct;76(8):893-9. doi: 10.1038/ki.2009.289. Epub 2009 Jul 29.

Dialysis-requiring acute renal failure increases the risk of progressive chronic kidney disease.

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1
Department of Medicine, University of California, San Francisco, 94143-0532, USA.

Abstract

To determine whether acute renal failure (ARF) increases the long-term risk of progressive chronic kidney disease (CKD), we studied the outcome of patients whose initial kidney function was normal or near normal but who had an episode of dialysis-requiring ARF and did not develop end-stage renal disease within 30 days following hospital discharge. The study encompassed 556,090 adult members of Kaiser Permanente of Northern California hospitalized over an 8 year period, who had pre-admission estimated glomerular filtration rates (eGFR) equivalent to or greater than 45 ml/min/1.73 m(2) and who survived hospitalization. After controlling for potential confounders such as baseline level of eGFR and diabetes status, dialysis-requiring ARF was independently associated with a 28-fold increase in the risk of developing stage 4 or 5 CKD and more than a twofold increased risk of death. Our study shows that in a large, community-based cohort of patients with pre-existing normal or near normal kidney function, an episode of dialysis-requiring ARF was a strong independent risk factor for a long-term risk of progressive CKD and mortality.

PMID:
19641480
PMCID:
PMC2771754
DOI:
10.1038/ki.2009.289
[Indexed for MEDLINE]
Free PMC Article

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