Experts recommend measuring a patient\u2019s albuminuria 3 months after hospitalization for acute kidney injury (AKI) to determine their risk for kidney disease progression, but such testing is often skipped. Could less expensive testing on a less rigid schedule provide an alternative? Yuenting Diana Kwong, MD, and colleagues examined the utility of testing total proteinuria instead.<\/p>\n
The researchers conducted a prospective multicenter cohort study including patients from the Chronic Renal Insufficiency Cohort (CRIC) who were hospitalized with AKI between 2013 and 2021. Participants\u2019 urine protein-to-creatinine ratio (UPCR) was measured within 1 year of hospital discharge, and the researchers used Cox proportional hazard models, focusing on c-statistics, to determine the test\u2019s ability to distinguish risk for kidney disease progression (defined as halving of estimated glomerular filtration rate [eGFR] or end-stage kidney disease).<\/p>\n
A CRIC cohort comprising 554 patients had their UPCR measured within 1 year of discharge after hospitalization for AKI. Of those, 82% had stage 1 AKI, 43% were female, and 51% were non-Hispanic Black. Their mean eGFR was 43 mL\/min\/1.73m2.<\/p>\n
The median UPCR, measured 147 days after AKI, was 0.36 mg\/g (interquartile range, 0.12-1.37 mg\/g). Over a mean follow-up period of 2.6 years, 124 patients experienced kidney disease progression.<\/p>\n
Higher post-AKI UPCR was linked to an increased risk for kidney disease progression, with a hazard ratio of 2.99 per doubling of proteinuria (95% CI, 2.54-3.52; c-statistic 0.80). A model adjusted for demographic and clinical risk factors demonstrated strong discrimination for kidney disease progression (c-statistic, 0.86). Use of renin\u2013angiotensin system inhibitors (RASi) declined after AKI, particularly among patients with more severe AKI and lower eGFR.<\/p>\n
The authors concluded that UPCR evaluation within 1\u00a0year after hospital discharge could be a viable alternative for assessing the kidney disease progression risk for patients after AKI. In addition, they found opportunities to enhance proteinuria management after AKI.<\/p>\n","protected":false},"excerpt":{"rendered":"Experts recommend measuring a patient\u2019s albuminuria 3 months after hospitalization for acute kidney injury (AKI) to determine their…\n","protected":false},"author":2,"featured_media":385074,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[163,85,46],"class_list":{"0":"post-385073","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-health","9":"tag-il","10":"tag-israel"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/385073","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=385073"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/385073\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/385074"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=385073"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=385073"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=385073"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}