By the bioMérieux Connection Editors
A 2012 study in Kidney International revealed that acute kidney injury (AKI) claims about 2 million lives a year in the U.S. The study also stated that of admitted patients diagnosed via traditional methods who died from hospital-acquired acute kidney injury, 31% of cases were avoidable, 43% experienced delayed diagnosis, and 54% had inadequate risk assessment.
In Part 1 of this series on AKI, we reviewed a recent study conducted by the Centers of Disease Control and Prevention (CDC) that revealed the incidence of AKI has increased dramatically among hospitalized patients with diabetes, but even more so among patients with no history of diabetes.
AKI is a major public health threat that is common, costly and potentially fatal in hospitalized patients1. Today, up to 50% of severely ill patients develop AKI,2 which can result in prolonged hospital stays3, chronic kidney disease4, a greater risk of mortality3, and higher cost of care.3 A recently published study by the Journal of Intensive Care Medicine5 reported a 33.9% reduction in the occurrence of moderate to severe AKI following cardiac surgery when clinicians used a biomarker-based assay to identify patients with moderate to severe risk for AKI and then implemented a bundle of care recommended by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines.
As the prevalence of AKI increases, so does the mounting personal and financial costs of this condition. The condition is associated with a tenfold increase in hospital mortality rates and a higher rate of chronic kidney disease among post-op patients.
With Timely Risk Assessment, AKI Can Be Dramatically Reduced
With AKI, rapid risk assessment is crucial. Delays in recognizing AKI can potentially lead to irreversible consequences, but the good news is that in many cases, adverse patient outcomes are avoidable if the condition is recognized and managed in a timely fashion.
According to guidance created by the Acute Dialysis Quality Initiative Consensus Conference (ADQICC) in 2013, much of the long-term damage of AKI could be mitigated or avoided if more timely and accurate biomarker diagnostics and predictive tools for the condition were utilized.
In the 2018 ADQI Conference Consensus5, the ADQICC stated, “Acute kidney injury (AKI) occurs in 7% to 18% of hospitalized patients and complicates the course of 50% to 60% of those admitted to the intensive care unit, carrying both significant mortality and morbidity.” The ADQICC goes on to say, “Consequently, the development of effective approaches to the prevention, early recognition, and management of AKI is necessary to reduce the burden of CKD and ESRD”.
1. Lewington AJP, Cerdá J, Mehta RL. Raising Awareness of Acute Kidney Injury: A Global Perspective of a Silent Killer. Kidney Int. 2013;84(3):457-467
2. Mandelbaum T, Scott DJ, Lee J, et al. Outcome of critically ill patients with acute kidney injury using the AKIN criteria. Crit Care Med. 2011;39(12):2659-2664
3. Dasta JF, Kane-Fill SL, Durtschi, AJ, Pathak DS, Kellum JA. Costs and outcomes of acute kidney injury (AKI) following cardiac surgery. Nephrol Dial Transplant. 2008;23:1970-1974.
4. Hobson C, Ozrazgat-Baslanti T, Kuxhausen A, et al. Cost and mortality associated with postoperative acute kidney injury. Ann Surg. 2014;00:1-8
5. Cardiac and Vascular Surgery–Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group. Am Heart Assoc. 2018;7:e008834; originally published June 1, 2018.
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