Acute kidney injury not associated with worsening kidney function in persons with CKD

The Researchers in the Chronic Renal InsufficieAnnals of Internal Medicinency Cohort (CRIC study) analyzed data from 3,150 persons with CKD to determine whether AKI is independently associated with subsequent kidney function trajectory. The data showed 612 AKIs in 433 persons with CKD over a median follow-up of 3.9 years. After adjusting for patient characteristics, such as prehospitalization estimated glomerular filtration rate (eGFR) slope and level of proteinuria, AKI did not predict worsening of subsequent kidney function trajectory. Instead, the authors highlight that their results show that much of the kidney disease observed after AKI may already be present before AKI. They recommend that clinicians instead focus on flattening the eGFR slope and treating proteinuria. The authors do acknowledge that a diagnosis of AKI does present an opportunity to identify high-risk patients and implement evidence-based interventions to slow CKD progression.

Reference:

Anthony N. Muiru, Jesse Y. Hsu,  Xiaoming Zhang, Lawrence J. Appel, Jing Chen, Debbie L. Cohen, Paul E. Drawz, Barry I. Freedman,  Raymond K. Hsu, James P. Lash, Kathleen D. Liu, Ian E. McCoy, Anna Porter, Panduranga Rao,  Ana C. Ricardo, Hernan Rincon-Choles, James Sondheimer, Jonathan Taliercio, https://doi.org/10.7326/M22-361.