Ben Mahmoud N, Hamouda M, Ben Salem M, Ben Salah M, Ghabi F, Hafi K, Bchir S, Letaief A, Skhiri H. Risk factors of mortality in patients with acute kidney injury: Retrospective cohort study with longitudinal follow-up. World J Nephrol 2026; 15(2): 117833 [DOI: 10.5527/wjn.v15.i2.117833]
Corresponding Author of This Article
Nouha Ben Mahmoud, Assistant Professor, Department of Nephrology, Dialysis and Renal Transplantation, Fattouma Bourguiba University Hospital, Farhat Hached Avenue 5001 Monastir, Monastir 5002, Tunisia. bmahmoudnouha@gmail.com
Research Domain of This Article
Demography
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Ben Mahmoud N, Hamouda M, Ben Salem M, Ben Salah M, Ghabi F, Hafi K, Bchir S, Letaief A, Skhiri H. Risk factors of mortality in patients with acute kidney injury: Retrospective cohort study with longitudinal follow-up. World J Nephrol 2026; 15(2): 117833 [DOI: 10.5527/wjn.v15.i2.117833]
World J Nephrol. Jun 25, 2026; 15(2): 117833 Published online Jun 25, 2026. doi: 10.5527/wjn.v15.i2.117833
Risk factors of mortality in patients with acute kidney injury: Retrospective cohort study with longitudinal follow-up
Nouha Ben Mahmoud, Mouna Hamouda, Meriem Ben Salem, Manel Ben Salah, Faten Ghabi, Khouloud Hafi, Sirine Bchir, Ahmed Letaief, Habib Skhiri
Nouha Ben Mahmoud, Mouna Hamouda, Meriem Ben Salem, Manel Ben Salah, Faten Ghabi, Khouloud Hafi, Sirine Bchir, Ahmed Letaief, Habib Skhiri, Department of Nephrology, Dialysis and Renal Transplantation, Fattouma Bourguiba University Hospital, Monastir 5001, Tunisia
Nouha Ben Mahmoud, Mouna Hamouda, Meriem Ben Salem, Manel Ben Salah, Faten Ghabi, Khouloud Hafi, Sirine Bchir, Ahmed Letaief, Habib Skhiri, Faculty of Medicine, University of Monastir, Monastir 5001, Tunisia
Nouha Ben Mahmoud, Meriem Ben Salem, Manel Ben Salah, Laboratory of Research on Biologically Compatible Substances, LR01ES17, Faculty of Dental Medicine, Monastir 5001, Tunisia
Co-first authors: Nouha Ben Mahmoud and Mouna Hamouda.
Author contributions: Ben Mahmoud N and Hamouda M contributed equally to this article and are the co-first authors of this manuscript; Ben Salem M, Ben Salah M, Ghabi F, Hafi K, Bchir S, Letaief A, and Skhiri H contributed equally to this manuscript and share last authorship; All authors thoroughly reviewed and approved the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of University of Monastir and because it was a retrospective study the committee didn’t provide us a certificate.
Informed consent statement: Signed informed consent was obtained from all participants contacted after discharge.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No data available.
Corresponding author: Nouha Ben Mahmoud, Assistant Professor, Department of Nephrology, Dialysis and Renal Transplantation, Fattouma Bourguiba University Hospital, Farhat Hached Avenue 5001 Monastir, Monastir 5002, Tunisia. bmahmoudnouha@gmail.com
Received: December 17, 2025 Revised: January 9, 2026 Accepted: February 25, 2026 Published online: June 25, 2026 Processing time: 180 Days and 19.3 Hours
Abstract
BACKGROUND
Acute kidney injury (AKI) is a clinical syndrome that, even after recovery of normal renal function, increases the short-term risk of developing chronic kidney disease and may contribute to mortality in hospitalized patients.
AIM
To assess patient survival and identify risk factors for mortality.
METHODS
We conducted a retrospective cohort study with longitudinal follow-up of patients hospitalized between January 2002 and December 2015, who had an episode of AKI as defined by the Kidney Disease Improving Global Outcomes 2012 guidelines, with return to normal renal function with follow-up extending up to 5 years after discharge, with a median follow-up of 7 years. Patient survival was verified using civil status records and by telephoning patients or their relatives. Risk factors were assessed using univariate and multivariate survival analyses. Short-term mortality was assessed between 3 months and 1 year, medium-term between 1 year and 5 years, and long-term beyond 5 years.
RESULTS
A total of 214 patients were included, with mortality data available for 193. Of these, 18 patients (9.3%) died within the short term (mean: 9.22 ± 0.67 months), 18 patients (10.2%) died within the medium term (mean: 36.27 ± 2.73 months), and 26 patients (16.5%) died within the long term (mean: 103.6 ± 6.63 months). The overall mean survival was 159 months. The Kaplan-Meier survival curve showed overall survival rates of 79%, 68%, and 57% at 5 years, 10 years, and 14 years, respectively. Identified mortality risk factors included age over 65, hypertension, diabetes, vascular disease, high Charlson comorbidity index, potassium levels above 5.5 mmol/L, pre-renal AKI, and the short-term development of chronic kidney disease.
CONCLUSION
These findings highlight the need to identify patients at higher risk of mortality following an AKI episode.
Core Tip: An article with a longitudinal follow-up study was conducted in a North African country for which data are lacking in the literature, with a long follow-up period of up to 18 years. We identified some mortality risk factors such as hypertension, age over 65 years, diabetes, vascular disease, high Charlson comorbidity index, potassium levels above 5.5 mmol/L, pre-renal acute kidney injury, and the short-term development of chronic kidney disease.
