Background: We aimed to find an optimal method of renal function in acute PE patients, by comparing the prognosis effect of acute kidney injury (AKI) and estimated glomerular filtration rate (eGFR) or combination of the two presentations of renal function on the prognosis of PE hospitalized.

Methods: Adult patients diagnosed with acute PE from 2009 to 2015, with available data of serum creatine (SCr) were enrolled from a multicenter registry in China. eGFR was calculated according to MDRD equation and AKI was defined according to the KDIGO definition, using the single assessment of SCr on admission. All-cause death, PE-related death and bleeding events during hospitalization were analyzed as endpoints.

Results: A total of 3575 PE patients with acute onset were enrolled into analysis. 253 (7.1%) patients were identified to have AKI on admission and eGFR < 60 mL/min/1.73 m2 was identified 406 (12.0%). The overlaps of different stages of AKI and levels of eGFR show that eGFR?60 ml/min·1.73m2 contains all the AKI patients (Figure 1). The rates of in-hospital mortality and PE-related death of patients with both AKI and eGFR?60 was both higher than only eGFR?60 without AKI (4.7% Vs 0.7% and 2.4% Vs 0, respectively, both p<0.05). The rates of bleeding and major bleeding were significantly higher in those had eGFR?60(9.2% Vs 5.6% and 4.5% Vs 1/5%, respectively, both p<0.05).

Conclusion: The presence of AKI was more associated with short-term mortality while eGFR was related to an increased incidence of bleeding events. Proper assessment of kidney function are important.