P0575TIME TO NEPHROLOGY CONSULTATION AND MORTALITY RISK IN COMMMUNITY ACQUIRED AKI. (6th June 2020)

• Record Type: Journal Article
• Authors: Acosta-Ochoa, Isabel; Coca, Armando; Lorenzo, Arturo; Mendiluce, Alicia
• Is Part Of: Nephrology dialysis transplantation. Volume 35(2020)Supplement 3
• Publication Date: 2020-06-06
• Subjects: Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfaa142.P0575
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background and Aims: Acute Kidney Injury (AKI) is the most frequent cause of Nephrology consultation. Although time to nephrology consultation (TNC) has been object of study, few works focus on its influence on in-hospital mortality in patients with community acquired AKI (CA-AKI). Method: We picked cases of CA-AKI, and divided individuals in dead in-hospital and survivors. We analyzed clinical and epidemiological variables, and categorized AKI with the KDIGO-2012 stages. We compared clinical outcomes and influence of TNC in mortality. Results: We included 420 patients, 92 (22%) in the mortality group. These individuals were older, had higher Charlson's Index, were hospitalized in critical care units, and were classified in KDIGO-2012 Stage 3 more frequently (Table 1). TNC was higher in the dead patients and was significantly associated with mortality HR 1.28 (CI 95% 1.03-1.55, P=0, 009). In KDIGO Stages 1 and 2 TNC was shorter in the survivors group, and in Stage 3 we found no differences. In general wards (medical and surgical), TNC was higher in the mortality group, with no differences in the consults from critical units (Table 1). In the survival curves we observe a decline in survival in patients with TNC ≥2 days since admission (Figure 1). Conclusion: We found that a longer TNC was associated with a poorer survival. This finding would indicate that earlier nephrology attention could impact in-hospital mortality. We interpret the longer TNC in less severe AKI stages as a warning of the unawareness and late recognition of AKI in other specialties. More well designed and larger studies are needed to prove that electronic alerts offer a survival benefit.