TY - JOUR
T1 - Obesity and recovery from acute kidney injury (Ob AKI)
T2 - A prospective cohort feasibility study
AU - MacLaughlin, Helen L.
AU - Blacklock, Rochelle M.
AU - Wright, Kelly
AU - Pot, Gerda
AU - Jayawardene, Satish
AU - McIntyre, Christopher W.
AU - MacDougall, Iain C.
AU - Selby, Nicholas M.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - 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.
AB - 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.
KW - acute renal failure
KW - chronic renal failure
KW - obesity
UR - http://www.scopus.com/inward/record.url?scp=85063265273&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-024033
DO - 10.1136/bmjopen-2018-024033
M3 - Article
AN - SCOPUS:85063265273
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e024033
ER -
