Prognosis

Recovery for AKI is variable and depends on cause of injury and the severity and duration of AKI.[213]

There is an independent association of AKI with a higher risk of death.[214][213][215] In-hospital mortality rates associated with AKI vary from 6% to 80%, and there is increased long-term mortality in those with AKI surviving hospitalisation.[215]

Up to 6% of patients admitted to the intensive care unit have AKI requiring renal replacement therapy.[20][213][216] In hospital, when AKI requires dialysis, mortality exceeds 50%; those with multi-organ failure are at greatest risk.[17][20][216] Mortality rates are high due to death from underlying disease and complications, not just the AKI.

Five-year survival rates in patients with AKI requiring renal replacement therapy range from 15% to 35% (less than 10% of those patients are dialysis-dependent).[217]

AKI is irreversible in approximately 5% to 7% of adults and as many as 16% of older adult patients.[218] There is controversy as to whether prior AKI is a major risk factor leading to future chronic kidney disease, but increasing evidence of strong association mounts.[219][220][221]

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