ArticleBMC medical informatics and decision making2026
Outcomes of acute kidney injury patients with and without chronic kidney disease in intensive care units: a retrospective contrast analysis.
Article in BMC medical informatics and decision making, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChronic kidney disease (CKD) is a common complication among patients in the intensive care unit (ICU), however, the impact of pre-existing CKD on patient who were admitted to the ICU and diagnosed with acute kidney injury (AKI) remains controversial.
methodsCritically ill patients (18-90 years old) with AKI were enrolled as study participants from the Medical Information Mart for Intensive Care-III database. Patients with repeated ICU admissions and a length of stay less than 48 h were excluded. In-ICU mortality was considered the main endpoint, and multivariable Cox regression analyses were performed. Moreover, propensity score matching (PSM) was employed to adjust potential interference factors, and the three-year survival rate was analyzed using the Kaplan-Meier method.
resultsThis study included 20440 patients, divided into the pure AKI group (18441 patients) and the acute-on-chronic kidney disease (ACKD) group (1999 patients). Multivariable Cox regression analyses revealed lower in-ICU mortality in ACKD group than pure AKI group (7.0% versus 7.7%, hazard ratio (HR) 0.83, 95% confidence interval (CI) 0.69-0.99, P = 0.047), as well as after PSM (7.0% versus 9.9%, HR 0.79, 95% CI 0.63-0.99, P = 0.049). Statistically significant differences persisted when patients were stratified by AKI stages. The results demonstrated that preexisting CKD was associated with reduced in-ICU mortality among AKI stage 3 patients, regardless of the classification criteria used. However, the Kaplan-Meier method indicated a lower three-year survival in the ACKD group (P = 0.017).
conclusionAmong AKI patients in ICU, the ACKD group had lower ICU mortality compared to pure AKI group but experienced worse long-term survival.
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