Table 1.
Proposed tests and outcomes after AKI
Proposed tests after AKI | Time point of measurement | Type of study | Population | Timepoint of follow-up and outcomes |
---|---|---|---|---|
Creatinine/estimated glomerular filtration rate (eGFR) and electrolytes | After AKI | Retrospective population-based cohort | 14,651 hospital survivors | Associated with an excess risk of 30% renal decline and de novo CKD stage 4 over 10 years, and the risk decreased over time [26] |
eGRF at discharge after AKI | Retrospective multicenter cohort | 9,973 hospitalized patients | Associated with CKD stage 4 or higher at 1 year [11] | |
eGFR at 3 months after AKI | Multicenter prospective cohort | 1,538 participants, of whom 50% developed AKI | Associated with future deterioration in kidney function (halving of eGFR or end-stage kidney disease (ESKD)) at 4.7 years (HR 1.50 for each 10 mL/min/1.73 m2 decrease; 95% CI, 1.36–1.66) [14] | |
eGFR normal (>60 ml/min/1.73 m2) at 1 year after AKI requiring temporary dialysis | Single center retrospective | 396 patients | 8.8% developed CKD after a median of 5.3 years [60] | |
Albuminuria (urine albumin-to-creatinine ratio) and proteinuria (urine protein-to-creatinine ratio) | Albuminuria at 3 months after AKI | Multicenter prospective study | 1,538 participants, of whom 50% developed AKI | Associated with future deterioration in kidney function (halving of eGFR or ESKD) at 4.7 years (HR 1.53 for each doubling; 95% CI, 1.45–1.62) [14] Urine ACR better predicted kidney deterioration than eGFR, and UPCR had a stronger association than ACR (HR 1.98 vs 1.53) [14] |
Blood pressure | After AKI | Multicenter retrospective cohort | 2,451 previously normotensive adults | Increased risk of hypertension within 2 years (22% increase (95% CI, 12–33%) after multivariable adjustment, and the risk was higher with increased AKI severity [32] |
Screening for cardiovascular events (HF, MI, stroke, AF) | After AKI | Meta-analysis | 254,408 adults | Increased risk of HF up to three years (RR 1.58, 95%CI 1.46–1.72) Increased risk of MI up to three years (RR 1.40, 95%CI 1.23–1.59) [34] |
After AKI | Retrospective multicenter cohort | 146,941 adults | Increased risk of HF at one year (HR 1.44, 95%CI 1.33–1.56) [35] | |
After AKI | Meta-analysis | 254,408 adults | Increased risk of stroke at three years (RR 1.15, 95%CI 1.03–1.28) [34] | |
After AKI | Retrospective population-based cohort | 21,556 critically ill survivors | Increased risk of HF (HR 1.33, 95%CI 106–1.66 for stage 1 and HR 1.45, 95%CI 1.14–1.84 for stages 2–3) and MI (HR 1.51, 95%CI 1.05–2.18 for stages 2–3) up to three years [61] | |
After AKI requiring dialysis | Retrospective cohort | 41,463 patients | Increased risk of subsequent atrial fibrillation (AF) after 6.9 years (HR 1.30; 95% CI, 1.07–1.58) compared to non-AKI [37]. | |
Serum glucose | After AKI requiring temporary dialysis | Retrospective population-based cohort | 13,228 adults | Increased risk of diabetes within 6 years with mortality as a competing risk factor (HR 1.18, 95%CI 1.07–1.30) [39] |
Serum lipids |