Small Link Seen for Acute Kidney Injury, Worsening of Kidney Function in CKD

THURSDAY, July 13, 2023 (HealthDay News) -- For patients with chronic kidney disease (CKD), the association between mild-to-moderate acute kidney injury (AKI) and worsening subsequent kidney function is small in fully adjusted models, according to a study published online July 11 in the Annals of Internal Medicine.

Anthony N. Muiru, M.D., M.P.H., from the University of California in San Francisco, and colleagues conducted a multicenter prospective cohort study involving 3,150 patients with CKD to examine the independent association with subsequent kidney function trajectory.

The researchers found that 433 participants had at least one AKI episode during a median follow-up of 3.9 years. Of the episodes, 92 percent had stage 1 or 2 severity. After AKI, there were decreases seen in estimated glomerular filtration rate (eGFR) based on serum creatinine levels and based on cystatin C levels (−2.30 [95 percent confidence interval, −3.70 to −0.86] and −3.61 [−6.39 to −0.82] mL/min/1.73 m², respectively). The decreases were attenuated to −0.38 (−1.35 to 0.59) and 0.15 (−2.16 to 1.86), respectively, in fully adjusted models. Estimates of changes in eGFR slope after AKI determined by serum creatinine or cystatin C levels were also not significant (0.04 [−0.30 to 0.38] and −0.56 [−1.28 to 0.17] mL/min/1.73 m², respectively, per year).

"This study more rigorously addressed methodological limitations presented in prior published studies to conclude that the independent association between mild-to-moderate AKI and worsening subsequent kidney function trajectory appears to be small," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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