Cao CC, et al. - Researchers performed a retrospective analysis of adult inpatients with acute exacerbations of COPD (AECOPD), to compare prevalence, risk factors, and outcomes for these patients with community-acquired acute kidney injury (AKI) [(CA-AKI)] and hospital-acquired AKI (HA-AKI). In this study, a total of 1,768 patients were included, 280 patients were identified with CA-AKI and 97 patients were with HA-AKI. In patients with AECOPD requiring hospitalization, a common occurrence of AKI was reported. Although similar demographics and risk factors were noted for both CA-AKI and HA-AKI but a more common incidence of CA-AKI was reported compared to HA-AKI. Nevertheless, worse short-term outcomes were observed in patients with HA-AKI.

Methods

• Researchers retrospectively analyzed data from adult inpatients with AECOPD in this study conducted from January 2014 to January 2017.
• Study included 1,768; 280 patients were identified with CA-AKI and 97 patients were with HA-AKI.

Results

• An overall AKI prevalence of 21.3% was reported; the estimated prevalence of CA-AKI was 15.8% and that of HA-AKI was 5.5%.
• Findings revealed a higher prevalence of chronic kidney disease (CKD) and lower prevalence of chronic cor pulmonale among patients with CA-AKI vs patients with HA-AKI.
• They identified similar risk factors for developing HA-AKI and CA-AKI, such as being elderly, requirement for mechanical ventilation, and a history of coronary artery disease and CKD.
• Stage 3 AKI and worse short-term outcomes were more likely to be observed among patients with HA-AKI.
• Relative to patients with CA-AKI, need for non-invasive mechanical ventilation (31.3% vs 16.8%; P=0.003) and a longer duration of mechanical ventilation (11 days vs 8 days; P=0.020), longer hospitalization (14 days vs 12 days; P=0.038), and higher inpatient mortality (32.0% vs 13.2%; P < 0.001) were more likely to be reported among those with HA-AKI.
• Worse (multivariate-adjusted) inpatient survival was reported in patients with HA-AKI vs in those with CA-AKI (hazard ratio, 1.7 [95% confidence interval, 1.03–2.81; P=0.038] for the HA-AKI group).