Community acquired vs hospital acquired acute kidney injury. mortality and timing of renal replacement therapy

Objectives To analyse differences in survival between patients presenting community acquired advanced acute kidney injury (CAKIN3) and hospital acquired advanced acute kidney injury (HAKIN3). We also evaluated Renal Replacement Therapy (RRT) timing impact in these two populations. Methods We studied a cohort of 217 critically ill patients all of them presenting advanced acute kidney injury (AKIN3) at some point of their hospital stay. Patients with previous advanced chronic kidney disease (CKD5) were excluded. CAKIN3 was defined as those patients who presented AKIN3 at hospital admission and HAKIN3 was defined as those patients who presented no AKI at hospital admission. Both groups studied presented AKIN3 within the first 24h of ICU admission. To evaluate RRT timing impact we defined as Early RRT those patients whom were initiated on RRT within the first 48 hours from hospital admission (CAKIN3) or within the first 48 hours from ICU admission (HAKIN3). Patients with more than 7 days from hospital admission (CAKIN3) or ICU admission (KAKIN3) to RRT initiation were both excluded from RRT timing analysis. Non RRT control group was also included in timing analysis.