Long-Term Outcomes of Acute Kidney Injury

Goldberg, Ryan; Dennen, Paula

doi:10.1053/j.ackd.2008.04.009

Cited by 123 publications

(94 citation statements)

References 60 publications

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“…CPB-AKI has been consistently shown to increase both morbidity (4) and mortality (5). Likewise, AKI may also affect quality of life (6) and has an effect on mortality beyond the perioperative period (7).…”

Section: Introductionmentioning

confidence: 99%

Follow-Up Renal Assessment of Injury Long-Term After Acute Kidney Injury (FRAIL-AKI)

Cooper

Claes

Goldstein

et al. 2016

Clinical Journal of the American Society of Nephrology

113

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Background and objectives Novel urinary kidney damage biomarkers detect AKI after cardiac surgery using cardiopulmonary bypass (CPB-AKI). Although there is growing focus on whether AKI leads to CKD, no studies have assessed whether novel urinary biomarkers remain elevated long term after CPB-AKI. We assessed whether there was clinical or biomarker evidence of long-term kidney injury in patients with CPB-AKI.Design, setting, participants, & measurements We performed a cross-sectional evaluation for signs of chronic kidney injury using both traditional measures and novel urinary biomarkers in a population of 372 potentially eligible children (119 AKI positive and 253 AKI negative) who underwent surgery using cardiopulmonary bypass for congenital heart disease at Cincinnati Children's Hospital Medical Center between 2004 and 2007. A total of 51 patients (33 AKI positive and 18 AKI negative) agreed to long-term assessment. We also compared the urinary biomarker levels in these 51 patients with those in healthy controls of similar age.Results At long-term follow-up (mean duration6SD, 760.98 years), AKI-positive and AKI-negative patients had similarly normal assessments of kidney function by eGFR, proteinuria, and BP measurement. However, AKI-positive patients had higher urine concentrations of IL-18 (48.5 pg/ml versus 20.3 pg/ml [P=0.01] and 20.5 pg/ml [P,0.001]) and liver-type fatty acid-binding protein (L-FABP) (5.9 ng/ml versus 3.9 ng/ml [P=0.001] and 3.2 ng/ml [P,0.001]) than did AKI-negative patients and healthy controls.Conclusions Novel urinary biomarkers remain elevated 7 years after an episode of CPB-AKI in children. However, there is no conventional evidence of CKD in these children. These biomarkers may be a more sensitive marker of chronic kidney injury after CPB-AKI. Future studies are needed to understand the clinical relevance of persistent elevations in IL-18, kidney injury molecule-1, and L-FABP in assessments for potential long-term kidney consequences of CPB-AKI.

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Section: Introductionmentioning

confidence: 99%

Follow-Up Renal Assessment of Injury Long-Term After Acute Kidney Injury (FRAIL-AKI)

Cooper

Claes

Goldstein

et al. 2016

Clinical Journal of the American Society of Nephrology

113

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“…18 It has been argued that a failure to improve outcome may be explained by the use of more aggressive medical and surgical interventions in an ageing population. Most patients who survive following AKI will recover kidney function, 19 but it is now recognised that a significant proportion of them will have subclinical functional defects and a smaller proportion will be at risk of developing CKD. 20 Table 7.…”

Section: Urine Chemistry Pre-kidney Aki Atnmentioning

confidence: 99%

Acute kidney injury

Lines

Lewington

2009

Clinical Medicine

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“…It has been well documented that the majority of patients who survive following AKI will recover kidney function. 13 However, it is now recognized that a significant proportion of these patients will have subclinical functional defects and that a smaller proportion will be at risk of developing CKD.…”

Section: Biomarkers For Akimentioning

confidence: 99%

Acute kidney injury: how do we define it?

Lewington

Sayed

2009

Ann Clin Biochem

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Over recent years, there has been welcome increased interest in acute kidney injury (AKI) and its association with patient outcome. The term AKI has replaced the term acute renal failure (ARF) and encompasses all types of ARF. New definitions and staging systems for AKI have been proposed, which have stimulated a multitude of different studies to evaluate their clinical utility. These recent advances need to be communicated to the wider health care community so that we are using a shared nomenclature. In 2009 the National Confidential Enquiry into Patient Outcome and Death AKI study ('Adding Insult to Injury') announced its findings and recommendations. The report recommended that the detection of AKI and its management should be improved. These recommendations along with the adoption of the new staging systems will potentially have an impact on clinical biochemistry departments and exert an increased demand on resources. Running in parallel with these initiatives is the quest to discover novel biomarkers to detect AKI, the development and introduction of which will require laboratory support.

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Long-Term Outcomes of Acute Kidney Injury

Cited by 123 publications

References 60 publications

Follow-Up Renal Assessment of Injury Long-Term After Acute Kidney Injury (FRAIL-AKI)

Follow-Up Renal Assessment of Injury Long-Term After Acute Kidney Injury (FRAIL-AKI)

Acute kidney injury

Acute kidney injury: how do we define it?

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