{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:30:30Z","timestamp":1786480230517,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK-93770"],"award-info":[{"award-number":["R01DK-93770"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["K24DK090203"],"award-info":[{"award-number":["K24DK090203"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100016526","name":"George M. O'Brien Michigan Kidney Translational Core Center","doi-asserted-by":"crossref","award":["P30DK079310"],"award-info":[{"award-number":["P30DK079310"]}],"id":[{"id":"10.13039\/100016526","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK-93770"],"award-info":[{"award-number":["R01DK-93770"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["K24DK090203"],"award-info":[{"award-number":["K24DK090203"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100016526","name":"George M. O'Brien Michigan Kidney Translational Core Center","doi-asserted-by":"crossref","award":["P30DK079310"],"award-info":[{"award-number":["P30DK079310"]}],"id":[{"id":"10.13039\/100016526","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2025,7]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n Nonimmunologic AKI-related rehospitalizations post\u2013kidney transplant are associated with poorer long-term allograft and recipient outcomes.<\/jats:p>\n <\/jats:list-item>\n \n These data are not reported to United Network for Organ Sharing, and there are no datasets highlighting this important association; thus, our findings are valuable to clinicians.<\/jats:p>\n <\/jats:list-item>\n \n We hope to help the community create a cohort of higher risk transplant patients who need closer monitoring to potentially increase graft longevity<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n AKI is associated with an increased risk of CKD and ESKD. However, only limited studies have investigated the effect of AKI episodes on kidney transplant outcomes. This study evaluated the effect of rehospitalization associated with nonimmunologic AKI on long-term outcomes. Data on rehospitalization with AKI after kidney transplant are not reported to United Network for Organ Sharing, and thus, there are no large datasets available to study this association.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We completed chart reviews of 989 deceased donor kidney transplant recipients transplanted from 2010 to 2014 at 13 transplant centers in the Deceased Donor Study Consortium. Rehospitalizations up to 5 years post-transplant were included. The cause of rehospitalizations was adjudicated by a transplant nephrologist on the basis of the discharge diagnosis. Primary outcomes were the effect of AKI-related rehospitalization on death-censored graft failure and all-cause mortality. We excluded rehospitalizations because of acute rejection from the primary analysis. The cohort was linked to data from Organ Procurement and Transplantation Network supplied by United Network for Organ Sharing. Time-varying cox-proportional hazard models were used to examine the association between rehospitalization and outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We identified 200 (20%) recipients with at least one rehospitalization associated with AKI, 516 (52%) with rehospitalizations without AKI, and 273 (28%) without a rehospitalization post-transplant. Delayed graft function, donor age, and kidney donor profile index score differed between the three groups. We found a higher risk of death censored graft failure adjusted hazard ratio (aHR) 7.5 (95% confidence interval [CI], 4.0 to 13.8), all-cause graft failure aHR 6.7 (95% CI, 4.2 to 10.8), and all-cause mortality aHR 5.7 (95% CI, 2.7 to 11.8) for rehospitalizations associated with AKI compared with no rehospitalization. The non-AKI rehospitalizations also had significantly higher rates of measured outcomes; however, the associations were not as strong.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n AKI rehospitalizations were associated with a significantly increased risk of poorer graft outcomes, and thus, closer follow-up of this high-risk group is warranted.<\/jats:p>\n <\/jats:sec>","DOI":"10.34067\/kid.0000000759","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T12:00:26Z","timestamp":1741176026000},"page":"1158-1166","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Post\u2013Kidney Transplant Hospitalizations and Long-Term Outcomes"],"prefix":"10.34067","volume":"6","author":[{"given":"Divyanshu","family":"Malhotra","sequence":"first","affiliation":[{"name":"Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Alasfar","sequence":"additional","affiliation":[{"name":"Nephrology and Hypertension Department, Mayo Clinic, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2067-0514","authenticated-orcid":false,"given":"Heather","family":"Thiessen-Philbrook","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0885-8450","authenticated-orcid":false,"given":"Isaac E.","family":"Hall","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2510-1951","authenticated-orcid":false,"given":"Mona D.","family":"Doshi","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Michigan Medical School, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5305-9685","authenticated-orcid":false,"given":"Sumit","family":"Mohan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1440-069X","authenticated-orcid":false,"given":"Peter P.","family":"Reese","sequence":"additional","affiliation":[{"name":"Vanderbilt Center for Transplant Science, Vanderbilt University, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9051-7385","authenticated-orcid":false,"given":"Chirag R.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"issue":"1","key":"B1-20260205","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1681\/ASN.2007080837","article-title":"Acute kidney injury increases risk of ESRD among elderly","volume":"20","author":"Ishani","year":"2009","journal-title":"J Am Soc Nephrol."},{"issue":"9","key":"B2-20260205","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.2215\/CJN.00710113","article-title":"World incidence of AKI: a meta-analysis","volume":"8","author":"Susantitaphong","year":"2013","journal-title":"Clin J Am Soc Nephrol."},{"issue":"1","key":"B3-20260205","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.kint.2018.08.036","article-title":"Long-term risk of adverse outcomes after acute kidney injury: a systematic review and meta-analysis of cohort studies using consensus definitions of exposure","volume":"95","author":"See","year":"2019","journal-title":"Kidney Int."},{"issue":"1","key":"B4-20260205","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1681\/ASN.2016010105","article-title":"AKI and long-term risk for cardiovascular events and mortality","volume":"28","author":"Odutayo","year":"2017","journal-title":"J Am Soc Nephrol."},{"issue":"12","key":"B5-20260205","doi-asserted-by":"crossref","first-page":"3164","DOI":"10.1111\/ajt.12513","article-title":"Early rehospitalization after kidney transplantation: assessing preventability and prognosis","volume":"13","author":"Harhay","year":"2013","journal-title":"Am J Transplant."},{"issue":"4","key":"B6-20260205","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1053\/j.ajkd.2011.11.034","article-title":"Incidence and consequences of acute kidney injury in kidney transplant recipients","volume":"59","author":"Mehrotra","year":"2012","journal-title":"Am J Kidney Dis."},{"issue":"6","key":"B8-20260205","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1111\/ajt.13144","article-title":"Associations of deceased donor kidney injury with kidney discard and function after transplantation","volume":"15","author":"Hall","year":"2015","journal-title":"Am J Transplant."},{"issue":"1","key":"B9-20260205","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.kint.2018.08.047","article-title":"Deceased-donor acute kidney injury is not associated with kidney allograft failure","volume":"95","author":"Hall","year":"2019","journal-title":"Kidney 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Fail."},{"issue":"11","key":"B14-20260205","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.1097\/TP.0000000000002663","article-title":"Hospitalization trends for acute kidney injury in kidney transplant recipients in the United States, 2004-2014","volume":"103","author":"Garg","year":"2019","journal-title":"Transplantation."},{"issue":"10","key":"B15-20260205","doi-asserted-by":"crossref","first-page":"3209","DOI":"10.1016\/j.transproceed.2019.12.046","article-title":"Acute kidney injury in hospitalized kidney transplant recipients","volume":"52","author":"Camargo-Salamanca","year":"2020","journal-title":"Transplant Proc."},{"issue":"1","key":"B16-20260205","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/ctr.12660","article-title":"Incidence, etiology, and significance of acute kidney injury in the early post-kidney transplant period","volume":"30","author":"Panek","year":"2016","journal-title":"Clin Transplant."},{"issue":"7","key":"B17-20260205","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.2215\/CJN.00850122","article-title":"The pathophysiology of sepsis-associated AKI","volume":"17","author":"Kuwabara","year":"2022","journal-title":"Clin J Am Soc Nephrol."},{"issue":"4","key":"B18-20260205","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1053\/j.ackd.2017.05.005","article-title":"Acute kidney injury in transplant setting: differential diagnosis and impact on health and health care","volume":"24","author":"Abu Jawdeh","year":"2017","journal-title":"Adv Chronic Kidney Dis."},{"issue":"2","key":"B19-20260205","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.transproceed.2005.12.092","article-title":"Renal allograft hemodynamic and diameter changes after living donor transplantation","volume":"38","author":"Ardalan","year":"2006","journal-title":"Transplant Proc."},{"issue":"6","key":"B20-20260205","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s40620-020-00793-2","article-title":"AKI: an increasingly recognized risk factor for CKD development and progression","volume":"33","author":"Kurzhagen","year":"2020","journal-title":"J Nephrol."},{"issue":"6","key":"B21-20260205","doi-asserted-by":"crossref","first-page":"e0156532","DOI":"10.1371\/journal.pone.0156532","article-title":"Measures of global health status on dialysis signal early rehospitalization risk after kidney transplantation","volume":"11","author":"Harhay","year":"2016","journal-title":"PLoS One."}],"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000000759","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T19:58:52Z","timestamp":1786478332000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000000759"}},"subtitle":["A Prospective Multicenter Study"],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":20,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.34067\/kid.0000000759","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,5]]},"assertion":[{"value":"2024-09-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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