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Titolo Dialysis-requiring acute renal failure increases the risk of progressive chronic kidney disease
Autore Lowell J. Lo1, Alan S. Go1,2,3, Glenn M. Chertow4, Charles E. McCulloch3, Dongjie Fan2, Juan D. Ordon? ez5 and Chi-yuan Hsu1,2 - 1Department of Medicine, University of California, San Francisco, San Francisco, California, USA; 2Division of Research, Kaiser Permanente of Northern California, Oakland, California, USA; 3Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA; 4Department of Medicine, Stanford University, Stanford, California, USA and 5Division of Nephrology, Kaiser Permanente of Northern California Oakland Medical Center, Oakland, California, USA
Referenza Kidney International 2009; doi:10.1038/ki.2009.289
Contenuto 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 dialysisrequiring 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/1.73m2 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.
Data 10.08.2009
 
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