Studies of CKD outcomes in AKI by pre-AKI and post-AKI kidney function
| Progression | N | Clinical setting | Design | AKI exposure | Comparator | Follow-up | Pre-AKI baseline separation | Post-AKI recovery separation | Recovery definition (discharge unless otherwise stated) | Findings |
|---|---|---|---|---|---|---|---|---|---|---|
| Bucaloiu et al12 | 1610 | Unselected | Cohort | Cr rise >50% | No AKI | 3.3 years* | CKD excluded | Recovered only | Within 10% baseline | Development of new CKD stage 3/1000 person-year 28.1 AKI vs 13.1 no AKI (HR 1.91†) |
| Ishani et al18 | 7197 | Unselected | Cohort | Code | No AKI or CKD code | 2 years | Y by code alone | N | – | ESKD/1000 person-year (HR vs no code) AKI and CKD 79.45 (HR 41.2†) AKI 24.52 (HR 13†) CKD only 19.88 (HR 8.43†) No Code 2.08 (reference) |
| Jones et al14 | 719 | Unselected | Cohort | Code | No AKI | 2.5 years* | CKD excluded | Recovered only | Within 10% Baseline | HR for new CKD stage 3 (15% of AKI vs 3% of no AKI patients) 3.82† |
| van Kuijk et al26 | 493 | Postoperative | Cohort | 10% Cr change by day 2 post-op | No AKI | 5 years* | CKD excluded | Y | Within 10% baseline at day 3 | Development of new CKD 11% if no AKI, 32% if AKI recovered (HR 3.4†), 36% if AKI without recovery (HR3.6†) |
| Wu et al20 | 4393 | Postoperative | Cohort | Cr rise (RIFLE, or 50% rise if previous CKD) | No AKI and no CKD | 4.76 years* | Y by GFR>/<45 | Y | Within 50% baseline | Development of ESKD (vs no code) AKI only 4.64†, CKD only 40.86†, AKI and CKD 91.69† Stratified by recovery AKI+CKD+without recovery 212.73† AKI+CKD+recovery 74.07† AKI only+without recovery 60.95† AKI only+recovery 4.5† |
*Mean/median.
†Statistically significant p<0.05.
–, Outcome not addressed by study; AKI, acute kidney injury; CKD, chronic kidney disease; Cr, serum creatinine; eGFR, estimated glomerular filtration rate; ESKD, end-stage renal disease (dialysis >90 days); ITU, intensive therapy unit; N, outcome addressed but not per quality criterion; RRT, renal replacement therapy.