Table 1.
Areas of Uncertainty/Knowledge Gaps in Our Understanding of the Long-Term Outcomes of AKI | Suggestions for Next Steps |
---|---|
To what degree the association between AKI and mortality is causal | Prospective data collection with adequate consideration of confounding variables, intervention studies that demonstrate reduced mortality |
Understanding of the mechanism of the link between AKI and CKD in humans | Translation of animal models to humans; clinical studies incorporating methods that improve mechanistic understanding of the AKI to CKD transition in humans (e.g., biopsy, biomarkers, or imaging) |
Incorporation of etiologic factors into assessment and definition of AKI | Development of tools that include AKI etiology in assessment; prospective data collection focusing on precise etiology of AKI |
Optimal measurement of kidney function following AKI | Consensus definition to allow for harmonization of data going forward |
Understanding the incidence of albuminuria post-AKI because this might be a potential target for future intervention | Incorporation of albuminuria into CKD definition post-AKI in line with the KDIGO CKD definition; further study of albuminuria as an independent risk factor for adverse outcomes in a post-AKI setting |
Establish the role of existing or novel biomarkers in the recovery phase of AKI to improve risk stratification and/or provide mechanistic insights into the AKI to CKD transition | Collection of biomarkers at time of AKI combined with collection of biomarkers during recovery |
Availability of interventions that reduce long-term sequelae following AKI | Studies into optimal or tailored follow-up strategies and research into gaps in current post-AKI care |
KDIGO, Kidney Disease Improving Global Outcomes.