Esposito Pasquale, Cappadona Francesca, Prenna Stefania, Marengo Marita, Fiorentino Marco, Fabbrini Paolo, Quercia Alessandro Domenico, Naso Erika, Garzotto Francesco, Russo Elisa, Zanetti Valentina, Piscia Riccardo, Capponi Andrea, Castellano Giuseppe, Cantaluppi Vincenzo
Department of Internal Medicine and and Medical Specialties (DIMI), University of Genova, Genova, Italy.
Unit of Nephrology, Dialysis and Transplantation, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Sci Rep. 2025 Apr 24;15(1):14261. doi: 10.1038/s41598-025-96236-8.
Acute Kidney Injury (AKI) is a common condition with significant impact on morbidity, mortality, and healthcare costs. This study explores the epidemiology of AKI, highlighting key factors and outcomes. In a retrospective study we evaluated patients admitted to hospital from 2016 to 2019, excluding those with pre-existing chronic kidney disease (CKD) stages 4-5. Data were extracted from hospital databases, with AKI defined by changes in serum creatinine (sCr) according to KDIGO criteria. Additionally, AKI was classified as "de novo" or as AKI on CKD in the subgroup of patients with available pre-hospital eGFR. Outcomes included mortality, hospital stay duration (LOS), AKI recovery, and persistent AKI. Of 87,087 patients, 17,946 (20.6%) developed AKI. AKI patients were older, with more comorbidities, and had significantly higher mortality (17.7% vs. 4.3%, p < 0.001). AKI was associated with in-hospital mortality (HR 1.23, 95% CI 1.16-1.30), longer LOS, and ICU admission. Mortality increased with AKI severity. Considering the 34,285 patients (39% of the total cohort) with pre-hospital eGFR, AKI occurred in 17.3% patients without previous CKD and in 31.1% of patients with previous CKD. These patients presented higher incidence of ICU admission and mortality. Additionally, 17.6% of AKI patients had persistent kidney dysfunction at discharge, often requiring extended hospitalization and ICU care. The substantial impact of AKI on both short- and potentially long-term health emphasizes the importance of early detection, personalized management, and structured follow-up to enhance outcomes and reduce CKD progression risk.
急性肾损伤（AKI）是一种常见病症，对发病率、死亡率和医疗成本有重大影响。本研究探讨了AKI的流行病学，突出了关键因素和结局。在一项回顾性研究中，我们评估了2016年至2019年入院的患者，排除了那些已患有慢性肾脏病（CKD）4 - 5期的患者。数据从医院数据库中提取，根据KDIGO标准通过血清肌酐（sCr）变化定义AKI。此外，在有院前估算肾小球滤过率（eGFR）数据的患者亚组中，AKI被分类为“新发”或CKD基础上的AKI。结局包括死亡率、住院时间（LOS）、AKI恢复情况和持续性AKI。在87,087例患者中，17,946例（20.6%）发生了AKI。AKI患者年龄更大，合并症更多，死亡率显著更高（17.7%对4.3%，p < 0.001）。AKI与院内死亡率（风险比1.23，95%置信区间1.16 - 1.30）、更长的住院时间和入住重症监护病房（ICU）相关。死亡率随AKI严重程度增加。在34,285例有院前eGFR的患者（占总队列的39%）中，既往无CKD的患者中17.3%发生了AKI，既往有CKD的患者中31.1%发生了AKI。这些患者入住ICU和死亡率更高。此外，17.6%的AKI患者出院时存在持续性肾功能不全，常常需要延长住院时间和ICU护理。AKI对短期和潜在长期健康的重大影响强调了早期检测、个性化管理和结构化随访的重要性，以改善结局并降低CKD进展风险。
