STARD flow diagram of patients in the Yale biopsy cohort showing participants included in final analysis. We defined acute kidney disease (AKD) according to the Kidney Disease Improving Global Outcomes criteria. AKD includes (1) AKI (rise in serum creatinine ≥0.3 mg/dl in 48 hours or ≥50% rise in 7 days), (2) new kidney failure (GFR<60 for <3 months), or (3) slowly progressive kidney failure (≥35% drop in GFR in 3 months, or 50% serum creatinine rise in <3 months). 95% CI, 95% confidence interval; STARD, Standards for the Reporting of Diagnostic Accuracy Studies.