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Impact of acute kidney injury on long-term adverse outcomes in obstructive uropathyopen access

Authors
Yang, JihyunSun, Bong GyunMin, Hyeon-JinSon, Young-BinKim, Tae BumLee, JonghyunOh, Se WonKim, Myung-GyuCho, Won YongAhn, Shin YoungKo, Gang-JeeKwon, Young JooCha, Jin JooKang, Young SunCha, Dae RyongJo, Sang-Kyung
Issue Date
Dec-2021
Publisher
Nature Publishing Group
Citation
Scientific Reports, v.11, no.1
Indexed
SCIE
SCOPUS
Journal Title
Scientific Reports
Volume
11
Number
1
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/55043
DOI
10.1038/s41598-021-03033-0
Abstract
Obstructive uropathy is known to be associated with acute kidney injury (AKI). This study aimed to investigate the etiologies, clinical characteristics, consequences and also assess the impact of AKI on long-term outcomes. This multicenter, retrospective study of 1683 patients with obstructive uropathy who underwent percutaneous nephrostomy (PCN) analyzed clinical characteristics, outcomes including progression to end-stage kidney disease (ESKD), overall mortality, and the impact of AKI on long-term outcomes. Obstructive uropathy in adults was most commonly caused by malignancy, urolithiasis, and other causes. AKI was present in 78% of the patients and was independently associated with preexisting chronic kidney disease (CKD). Short-term recovery was achieved in 56.78% after the relief of obstruction. ESKD progression rate was 4.4% in urolithiasis and 6.8% in other causes and older age, preexisting CKD, and stage 3 AKI were independent factors of progression. The mortality rate (34%) was highly attributed to malignant obstruction (52%) stage 3 AKI was also an independent predictor of mortality in non-malignant obstruction. AKI is a frequent complication of adult obstructive uropathy. AKI negatively affects long-term kidney outcomes and survival in non-malignant obstructions. A better understanding of the epidemiology and prognostic factors is needed for adult obstructive uropathy.
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Ahn, Shin Young
Guro Hospital (Department of Nephrology and Hypertension, Guro Hospital)
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