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Editorial
September 16, 2009

Chronic on Acute Renal FailureLong-term Implications of Severe Acute Kidney Injury

Author Affiliations

Author Affiliations: Renal Division, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Massachusetts (Dr Waikar); and Division of Nephrology, Stanford University School of Medicine, Palo Alto, California (Dr Winkelmayer).

JAMA. 2009;302(11):1227-1229. doi:10.1001/jama.2009.1364

Every year more than 1 million hospitalizations in the United States are complicated by acute kidney injury, accounting for an estimated $10 billion in excess costs to the health care system.14 Acute kidney injury has been shown to be a potent predictor of excess length of stay, morbidity, and mortality in a number of clinical settings. The incidence of acute kidney injury has increased more than 4-fold since 1988 and is estimated to have a yearly population incidence of more than 500 per 100 000 population2,3—higher than the yearly incidence of stroke.5,6 Survival from an episode of acute kidney injury may be increasing by virtue of advances in critical care medicine and dialysis technologies. In short, more hospitalized patients are being discharged alive after an episode of acute kidney injury.

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