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Purpose <p>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.</p> Methods <p>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&#xa0;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.</p> Results <p>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.</p> Conclusions <p>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.</p> <p><i>Registration for the multicenter prospective cohort study</i>: registration number ChiCTR (ECH-13003934).</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月23日

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  • Pengchao Tian,
  • Xiuming Xi,
  • Jin Zhang,
  • Xi Zheng,
  • Wei Liu,
  • Tianjun Wu,
  • Jingyi Wang,
  • Lifeng Huang,
  • Yue Zheng,
  • Wenxiong Li

摘要

Purpose

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.

Methods

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.

Results

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.

Conclusions

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).