There is an independent association of AKI with a higher risk of death. In-hospital mortality rates associated with AKI vary from 6% to 80%, and there is increased long-term mortality in those with AKI surviving hospitalization.
Up to 6% of patients admitted to the intensive care unit have AKI requiring renal replacement therapy. In hospital, when AKI requires dialysis, mortality exceeds 50%; those with multiorgan failure are at greatest risk. 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).
AKI is irreversible in approximately 5% to 7% of adults and as many as 16% of older adult patients. There is controversy as to whether prior AKI is a major risk factor leading to future chronic kidney disease, but evidence increasingly favors a strong association.
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