Acute Kidney Injury and Chronic Kidney Disease Progression
Oct 16, 2023
auto_awesome
Dr. Chi-yuan Hsu and Dr. Anthony Muiru discuss the relationship between acute kidney injury (AKI) and chronic kidney disease progression. They explore the impact of AKI on kidney function, the correlation between duration of obstruction and renal fibrosis, and the challenge of establishing an individual's baseline kidney function. They also highlight the importance of comprehensive data in studying CKD progression and distinguishing between AKI and CKD based on creatinine levels.
Mild to moderate acute kidney injury (AKI) does not independently predict worsening kidney function in patients with chronic kidney disease (CKD), highlighting the need for appropriate renal care and follow-up even if AKI occurs.
A nuanced understanding of AKI is necessary, as it may indicate underlying kidney disease progression, providing an opportunity to identify high-risk individuals and implement preventive measures.
Deep dives
AKI does not predict worsening kidney function
This podcast episode discusses a study on the association between acute kidney injury (AKI) and the progression of chronic kidney disease (CKD). The study found that mild to moderate AKI did not independently predict worsening kidney function in patients with CKD. The researchers took into account factors such as estimated glomerular filtration rate (GFR) slope and proteinuria before AKI, and concluded that the association between AKI and worsening kidney function trajectory appears to be small. The study emphasizes the importance of identifying patients with CKD and providing appropriate renal care and follow-up, even if AKI occurs.
Understanding the study design and patient population
The study analyzed data from the Chronic Renal Insufficiency Cohort (CRIC) study, which is one of the largest studies on chronic kidney disease. The patient population included over 3,000 participants, with a mix of gender, age, and racial diversity. The study purposely oversampled individuals who self-identified as non-Hispanic Black, as they face a higher risk of kidney disease. This patient population is representative of those typically seen in clinical practice, making the findings applicable to healthcare professionals. The study's internal validity was ensured through a strict research protocol and annual measurement of kidney function.
Interpreting the results and implications for clinical practice
The study did not support the widely held belief that AKI always leads to the deterioration of kidney function in patients with CKD. It highlighted the need for a nuanced understanding of AKI. While AKI does not necessarily cause a significant decline in kidney function, it still provides crucial information about a patient's kidney health. AKI episodes may indicate underlying kidney disease progression, such as pre-existing proteinuria and a steeper estimated GFR slope. Healthcare professionals should consider AKI as an opportunity to identify high-risk individuals and provide appropriate renal care and monitoring. However, the study emphasizes the importance of screening individuals for kidney disease and implementing preventive measures to address the overall burden of kidney disease.
Dr. Centor discusses the risk for progression of chronic kidney disease after an episode of acute kidney injury with Drs. Chi-yuan Hsu and Anthony Muiru.
Get the Snipd podcast app
Unlock the knowledge in podcasts with the podcast player of the future.
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode
Save any moment
Hear something you like? Tap your headphones to save it with AI-generated key takeaways
Share & Export
Send highlights to Twitter, WhatsApp or export them to Notion, Readwise & more
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode