Impact of renal recovery on in-hospital and post-discharge mortality.
Alberto Augusto Martins Paiva, Marcia Cristina da Silva Magro, Paulo Percio Mota Magro and 1 others
PMID 38047745WHAT IT FOUND
Renal recovery was linked to lower in-hospital death, but it was not linked to death after discharge.
The cohort was small and single-center, so this is an association, not proof that recovery causes survival.
Key findings
01Total renal recovery was associated with lower odds of in-hospital death (OR 0.15, 95% CI 0.03-0.73, p=0.019), but not with post-discharge death (OR 0.83, 95% CI 0.32-2.19, p=0.711).
02Patients with hyperthermia during the ward stay were 3.72 times more likely to die in hospital (95% CI 1.39-10.00, p=0.009).
03Patients dependent on hemodialysis after discharge were 11.19 times more likely to die after discharge, and patients who received blood transfusion during hospitalization were 19.28 times more likely to die after discharge (95% CI 2.17-57.84 and 3.44-108.13; p=0.004 and 0.001).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was single-center and included only 90 patients with hospital-acquired AKI, so the results may not apply to other hospitals or patient groups. Of 1,250 patients evaluated, 792 were lost because of short stay, death, or transfer, and 368 because of withdrawal or missing creatinine, so the followed group may not represent all admissions. The study was observational, so associations with renal recovery, hyperthermia, transfusion, and hemodialysis cannot prove that any of these caused death or that changing them would improve survival. Post-discharge follow-up depended on patient adherence to laboratory tests, and hemodynamic data came from electronic records, with urine output often not recorded or inaccurate. Several outcomes and many variables were analyzed, and some confidence intervals were wide, so the reported associations need confirmation.
The easy way to misread this
Do not read renal recovery as proof that improving kidney function will prevent death. This was an observational single-center cohort, and recovery was not associated with post-discharge death.