Title: Recovery from AKI in the critically ill: potential confounders in the evaluation
Authors: Schetz, Miet ×
Gunst, Jan
De Vlieger, Greet
Van den Berghe, Greet #
Issue Date: Sep-2015
Publisher: Springer International
Series Title: Intensive Care Medicine vol:41 issue:9 pages:1648-1657
Abstract: Purpose: Studies on recovery from acute kidney injury (AKI) in ICU patients yield
variable results. We assessed, in a heterogeneous ICU population, the impact of
different recovery definitions, of different exclusion criteria and of imputing missing
baseline creatinine on AKI recovery.
Methods: Secondary analysis of the EPaNIC-database. Recovery of kidney function in
patients who developed AKI in ICU was assessed at hospital discharge. We studied
recovery rates of different AKI stages with different definitions of recovery after
inclusion or exclusion of non-survivors and in patients with or without chronic kidney
disease (CKD). In addition, the impact of imputing missing baseline creatinine was
Results: 1310 AKI patients were studied of which 977 were discharged alive from
hospital. Rate of complete recovery (absence of KDIGO criteria) was markedly higher
in survivors than in all AKI patients (79.5% vs 67.0%), especially for more severe forms
of AKI. For patients with CKD, only the need for renal replacement therapy worsened
kidney outcome as compared with no-CKD patients. Using stricter definitions of
complete recovery significantly reduced its occurrence. New or worsening CKD
occurred in 30% of AKI survivors. In no-CKD patients with available baseline
creatinine, using an imputed baseline did not affect recovery. Patients with unavailable
baseline creatinine were different from those with known baseline and revealed
different recovery patterns.
Conclusion: These results indicate the need for rigorous description of AKI severity, the
included population, definitions and baseline creatinine handling in reports on AKI
ISSN: 0342-4642
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Intensive Care Medicine
× corresponding author
# (joint) last author

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