J.LEE1, S.LIU1, A.LIU1, J.J.LIU1, Y.M.SHAO1, K.ANG1, S.C.LIM1
Khoo Teck Puat Hospital1
Acute kidney disease (AKI) is one of the leading causes for mortality in hospitalized patients. We aim to identify the risk factors for AKI and assess the clinical outcomes after first episode of AKI in multi-ethnic Southeast Asian people with type 2 diabetes (T2D).
1684 participants with T2D were recruited from KTPH from 2011 to 2017. AKI was defined as having 1.5 folds or greater increment in serum creatinine concentration during a single hospitalization administration (modified KDIGO criteria). End stage kidney disease (ESKD), major adverse cardiovascular events (MACE) and all-cause mortality were identified through electronic medical records. Risk factors for AKI and the association of AKI with subsequent risks for ESKD, MACE and mortality were studied by Cox regression models.
During a median (IQR) of 3.9 (3.0 – 5.4) years follow-up, we identified 155 AKI events (0.9/100 patient-years). Multivariable Cox regression model suggested that older age, Malay and Indian ethnicity, CVD history, high HbA1c, low eGFR and high albuminuria were independently associated with risk for AKI after accounting for other demographic and clinical risk factors. Participants with AKI event(s) had a 1.82 (95% CI 1.08-3.06), 1.91 (1.18-3.10) and 3.78 (95% CI 2.63-5.22) folds higher risk for ESKD, MACE and all-cause mortality, respectively as compared to those without AKI events.
AKI is associated with greatly increased risk for adverse clinical outcomes. Older age, Malay/Indian ethnicity, CVD history, poor glycaemic control and concomitant kidney disease are potential risk factors for development of AKI.