#1251 Risk factors and long-term outcomes in a prospective acute kidney injury cohort in Korea

Abstract Background and Aims Acute kidney injury (AKI) is a common complication in severely ill patients, significantly worsening patient outcomes. Its occurrence leads to longer hospital stays and higher mortality rates. Moreover, AKI is a well-recognized risk factor for the development of hypertension, cardiovascular disease and chronic kidney disease (CKD) later in life. Despite the significance of AKI, there is a lack of longitudinal studies examining kidney outcomes following AKI in children in Korea. Method This study included children under 18 who were diagnosed with AKI at Seoul National University Children's Hospital from February 2016 to July 2021. Of the 781 patients, 763 patients were analyzed. The diagnosis of AKI was defined according to the Kidney Disease: Improving Global Outcomes guidelines. Participants were followed up at 1, 3, 6, and 12 months post-AKI development, with annual assessments thereafter. During these follow-ups, we measured estimated glomerular filtration rate (eGFR) to evaluate kidney function and overall health. Long-term major adverse kidney events (MAKE-LT) was defined as the occurrence of at least one of the following: all-cause mortality, long-term kidney replacement therapy (KRT, including transplantation or dialysis), or chronic kidney disease (CKD) stage 2–5. Results Among 763 patients with AKI (442 males [57.9%]; median [IQR] age, 5.8 [0.0–18.9] years), MAKE-LT occurred in 377 patients (49.4%). On multivariable analysis, prematurity (adjusted hazard ratio (aHR), 2.0; 95% confidence interval (CI), 1.3 to 3.1, P = 0.002) and chronic kidney disease or kidney disease (aHR, 1.8; 95% CI, 1.1 to 2.7, P = 0.011) were associated with MAKE-LT. Conclusion This study provides an in-depth characterization of a prospective AKI cohort in Korea, including baseline demographics, disease etiology, and long-term outcomes. Prematurity and chronic kidney disease were significant predictors of MAKE-LT, highlighting the need for targeted interventions in these high-risk populations.