#594 Long-term risk of incident/progressive chronic kidney disease, or end-stage kidney disease post-acute kidney injury: systematic review, meta-analysis (2024)

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Denise Mj Veltkamp

Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University

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Utrecht

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Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht University

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Cindy P Porras

Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht University

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Utrecht

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Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University

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Maarten B Kok

Saltro BV, Unilabs Netherlands

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Utrecht

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Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht University

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Wouter W van Solinge

Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University

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Saskia Haitjema

Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University

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Robin Wm Vernooij

Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University

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Utrecht

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Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht University

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Utrecht

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Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University

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Nephrology Dialysis Transplantation, Volume 39, Issue Supplement_1, May 2024, gfae069-1128-594, https://doi.org/10.1093/ndt/gfae069.1128

Published:

23 May 2024

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    Denise Mj Veltkamp, Cindy P Porras, Maarten B Kok, Marianne Verhaar, Wouter W van Solinge, Saskia Haitjema, Robin Wm Vernooij, #594 Long-term risk of incident/progressive chronic kidney disease, or end-stage kidney disease post-acute kidney injury: systematic review, meta-analysis, Nephrology Dialysis Transplantation, Volume 39, Issue Supplement_1, May 2024, gfae069–1128–594, https://doi.org/10.1093/ndt/gfae069.1128

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Abstract

Background and Aims

Little is known about which patients to follow-up after an episode of acute kidney injury (AKI) for future risks. The aim of this review is to assess the association between AKI and the incidence or progression of chronic kidney disease (CKD) or end-stage kidney disease (ESKD), stratified by subcategories of AKI-stages, -durations, and clinical settings.

Method

A systematic search of the literature in PubMed and Embase was performed by two reviewers to identify studies that examined CKD incidence (development of CKD stage ≥3), CKD progression (worsening of kidney function in patients with CKD stage ≥3), or ESKD, in patients with AKI versus patients without AKI. The risk of bias was assessed using the Newcastle-Ottawa Scale. Relative effect estimates (odds and hazard ratios) were pooled using a random effects model.

Results

In total, 48 retrospective and 13 prospective studies, encompassing 140.985 patients with AKI, were included in this review. All the studies were of moderate or high quality. The pooled effect ratio was 3.36 (95% confidence interval (CI) 2.68-4.03) for CKD incidence (n=31 studies). This remained 3.40 (95% CI 1.79-5.00) in a sub analysis including patients with a recovered kidney function post-AKI, and 1.49 (95% CI 1.44-1.55) in a sub analysis including patients with an AKI lasting less than 3 days (Fig.1). Overall, the effect ratio for CKD progression (n=11 studies) was 1.70 (95% CI 1.38-2.01) and 3.81 (95% CI 2.58-5.04) for ESKD (n=24 studies). The increased risk of these two outcomes were not seen in the sub analyses only including patients with AKI lasting less than 3 days. Overall, there is an observable higher risk for CKD incidence, CKD progression, and ESKD with increased AKI staging, although not always statistically significant. Minimal variations were observed across clinical settings.

Conclusion

In our review, including over 60 studies, we found that AKI was associated with an increased risk of CKD incidence, CKD progression, and ESKD. Patients with higher AKI-stages had even larger risks. Notably, even brief episodes of AKI (lasting less than 3 days) were associated with a higher risk of CKD incidence compared to patients without AKI. In contrary, the risk for ESKD is not enlarged in a sub analysis including patients with recovered kidney function compared to patients without AKI. These result warrant close monitoring of the kidney function post-AKI, specifically in patients with AKI lasting 3 days or longer. Future research should focus more on the risk of CKD progression in order to tailor follow-up care in these more vulnerable patients.

Figure 1:

#594 Long-term risk of incident/progressive chronic kidney disease, or end-stage kidney disease post-acute kidney injury: systematic review, meta-analysis (3)

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CKD incidence in patients with AKI versus patients without AKI, stratified for AKI lasting less than 3 days and 3 days or longer.

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© The Author(s) 2024. Published by Oxford University Press on behalf of the ERA.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Topic:

  • renal function
  • kidney failure, chronic
  • renal failure, acute
  • follow-up
  • renal trauma
  • embase
  • reviewers

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#594 Long-term risk of incident/progressive chronic kidney disease, or end-stage kidney disease post-acute kidney injury: systematic review, meta-analysis (2024)

FAQs

Who is eligible for the American kidney Fund grant? ›

To qualify for AKF assistance, patients may not exceed a household pretax income of 500% of the Federal Poverty Level (FPL) and liquid assets (excluding retirement accounts) may not exceed $30,000. We selected 500% of FPL as this is the same or slightly higher threshold used by federal assistance programs.

What is the charity for kidney dialysis patients? ›

Welcome - The National Kidney Foundation.

Is omeprazole kidney damage reversible? ›

PPIs like omeprazole have been associated with acute kidney injury (AKI). AKI is a sudden worsening of kidney function. Even though it's often reversible, it can be dangerous. AKI can cause a build-up of waste products in the body, and affect other organs like the brain and heart.

What is the renal patient and Donor Foundation? ›

The Renal Patient and Donor Foundation is a grassroots charity led by kidney patients and kidney donors for patients and donors. We work to support innovative projects that advance kidney care and kidney research for kidney patients and kidney donors.

Is American Kidney Fund a legitimate organization? ›

CharityWatch has designated the American Kidney Fund as an A+ Top-Rated Charity.

How does the American Kidney Fund work? ›

Our need-based financial assistance programs help patients with health insurance premiums, transportation costs, prescription medications, and many other necessities related to health care. And, our medically-reviewed education resources help people prevent and manage their kidney disease.

Is peanut butter good for your kidneys? ›

It's naturally low in carbohydrates, and has plenty of fiber to aid digestion. It's a good substitute for meat in a kidney diet plan. However, it's worth noting that 2 tablespoons of peanut butter also has 65 milligrams of oxalate, and high amounts of oxalate can contribute to kidney stones (54, 55).

What nuts are bad for kidney disease? ›

If you have a history of calcium oxalate stones, talk with your doctor or kidney dietitian about the need to limit oxalates. Almonds, mixed nuts without peanuts, and sesame seeds are high in oxalates.

Are bananas good for the kidneys? ›

Damaged kidneys build up potassium in the blood, resulting in serious heart problems. Potassium is present in bananas, other fruits and vegetables (such as potatoes, avocados and melons). People with advanced kidney disease are usually advised to avoid some fruits and vegetables, including bananas.

What are two drugs not to be used in kidney disease? ›

They may harm your kidneys. Your doctor may tell you not to take them or may change the dose. Medicines for pain and swelling, such as ibuprofen (Advil or Motrin) or naproxen (Aleve), can cause harm. So can some antibiotics and antacids.

What blood pressure meds should I avoid with kidney disease? ›

ACE inhibitors are go-to medications for managing high blood pressure and heart failure. And in these conditions, they can protect the kidneys. But ACE inhibitors are cleared out of the body through the kidneys, so they also carry a risk of causing kidney injury.

Are Tums bad for kidneys? ›

Tums rarely have serious side effects. But they're possible. These include kidney problems, like kidney stones, and heart problems. If you have certain health conditions, like kidney disease or heart failure, you may be at a higher risk for side effects of Tums.

Which fruit is best for the kidneys? ›

Here are 10 colorful, high-antioxidant foods for the kidney diet.
  1. Cranberries. Cranberries add a distinctive zing to sweet breads, muffins and other recipes like Easy Cranberry Salad. ...
  2. Plums. Black plums are higher in antioxidants than red. ...
  3. Blueberries. ...
  4. Blackberries/raspberries. ...
  5. Garlic. ...
  6. Apples. ...
  7. Strawberries. ...
  8. Red Bell Peppers.

What is the hardest blood type to match for a kidney transplant? ›

Abstract. Background: Patients with blood group O have disadvantages in the allocation of deceased donor organs in the Eurotransplant Kidney Allocation System and fewer ABO-compatible living donors.

What makes you eligible to give a kidney? ›

As a general rule, you should be 18 years or older. You must also have normal kidney function. There are some medical conditions that could prevent you from being a living donor. These include having uncontrolled high blood pressure, diabetes, cancer, HIV, hepatitis, or acute infections.

Who are candidates for kidney donation? ›

Kidney Donor Requirements and Qualifications

Age: You should be between 18 and 70. Health insurance: You must have health insurance. If you are uninsured, we can help you obtain coverage. Overall health: You must have normal kidney function.

What benefits can I claim if I have kidney failure? ›

You may be able to claim New Style Employment and support allowance with, or instead of Universal Credit. Personal Independent Payment (PIP) can help with extra living costs if you have both: A long-term physical or mental health condition or disability.

How does the kidney voucher program work? ›

The standard voucher is utilized when a family member or friend is in imminent need of a kidney transplant (within a year) and the donor would like to donate sooner rather than later. The person in imminent need will receive a voucher for a living donor kidney, which can be activated at any time.

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