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Obesity and recovery from acute kidney injury (Ob AKI): A prospective cohort feasibility study

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Helen L. MacLaughlin, Rochelle M. Blacklock, Kelly Wright, Gerda Pot, Satish Jayawardene, Christopher W. McIntyre, Iain C. MacDougall, Nicholas M. Selby

Original languageEnglish
Article numbere024033
JournalBMJ Open
Volume9
Issue number3
DOIs
Published1 Mar 2019

King's Authors

Abstract

Objectives To test the methodology of recruitment, retention and data completeness in a prospective cohort recruited after a hospitalised episode of acute kidney injury (AKI), to inform a future prospective cohort study examining the effect of obesity on AKI outcomes. Design Feasibility study. Setting Single centre, multi-site UK tertiary hospital. Participants 101 participants (67M; 34F) with a median age of 64 (IQR 53-73) years, with and without obesity, recruited within 3 months of a hospitalised episode of AKI. Outcome measures Feasibility outcomes were recruitment (>15% meeting inclusion criteria recruited), participant retention at 6 and 12 months (≥80%) and completeness of data collection. Exploratory measures included recovery from AKI (regaining >75% of pre-AKI estimated glomerular filtration rate [eGFR]) at 6 months, development or progression of chronic kidney disease (CKD) (kidney function decrease of ≥25% +rise in CKD category) at 12 months, and associations with poorer kidney outcomes. Results 41% of eligible patients consented to take part, exceeding the target recruitment uptake rate of 15%. Retention was 86% at 6 months and 78% at 12 months; 10 patients died and three commenced dialysis during the study. Data were 90%-100% complete. Median BMI was 27.9 kg/m 2 (range 18.1 kg/m 2-54.3 kg/m 2). 50% of the cohort had stage 3 AKI and 49% had pre-existing CKD. 46% of the cohort met the AKI recovery definition at 6 months. At 12 months, 20/51 patients developed CKD (39%) and CKD progression occurred in 11/49 patients (22%). Post-AKI interleukin-6 and cystatin-C were associated with 12 months decline in eGFR. Conclusions Feasibility to conduct a long-term observational study addressing AKI outcomes associated with obesity was demonstrated. A fully powered prospective cohort study to examine the relationships between obesity and outcomes of AKI is warranted.

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