Risk factors of acute kidney injury on chronic kidney disease and its prognostic impact on critically ill patients

This study aims to explore the risk factors, clinical characteristics, and prognostic impact of acute kidney injury (AKI) on chronic kidney injury (CKD) in critically ill patients. This study was based on a prospective, multi-center registry study that enrolled 225 CKD patients from 17 ICUs in China. Patients were divided into AKI on CKD (AoC) and non-AoC groups based on whether they were newly diagnosed with AKI within the first 7 days of ICU admission. The primary outcome was a composite of renal replacement therapy (RRT) and in-hospital mortality (IHM). Logistic and Cox regression analyses were used to identify independent risk factors for AKI and to assess the prognostic association between AoC and the outcome, respectively. There were 179 AoC patients, and 132 of them reached the primary outcomes. AoC was significantly associated with a higher risk of RRT and IHM [HR: 2.325, 95% CI 1.410–3.833]. Non-renal SOFA score ≥ 2.5, APACHE-II score ≥ 19.5, and CKD stage ≥ 3 were independently associated with AoC. AoC was significantly associated with an increased risk of RRT and IHM in critically ill patients with CKD. Non-renal SOFA score, APACHE-II score, and CKD stage were independently associated with AoC. Registration for the multicenter prospective cohort study: registration number ChiCTR (ECH-13003934).