Predictors of progression to chronic dialysis in survivors of severe acute kidney injury: a competing risk study

摘要: Survivors of acute kidney injury are at an increased risk developing irreversible deterioration in function and some cases, the need for chronic dialysis. We aimed to determine predictors dialysis death among survivors dialysis-requiring injury. used linked administrative databases Ontario, Canada, identify patients who were discharged from hospital after episode requiring remained free further least 90 days discharge between 1996 2009. Follow-up extended until March 31, 2011. The primary outcome was progression Predictors this evaluated using cause-specific Cox proportional hazards models, a competing approach calculate absolute risk. identified 4 383 with temporary in-hospital survived discharge. After mean follow-up 2.4 years, 356 (8%) initiated 1475 (34%) died. cumulative 13.5% by Kaplan-Meier method, 10.3% approach. accounting death, previous nephrology consultation (subdistribution hazard ratio (sHR) 2.03; 95% confidence interval (CI) 1.61-2.58), history disease (sHR3.86; CI 2.99-4.98), higher Charlson comorbidity index score (sHR 1.10; 1.05-1.15/per unit) pre-existing hypertension 1.82; 1.28-2.58) significantly associated Among initially become independent, subsequent is predicted disease, global comorbidity. This information can high progressive may benefit closer surveillance cessation phase illness.