Acute Kidney Injury Risk Varies Based on eGFR, Proteinuria

Both markers appear to be important for identifying at-risk patients

MONDAY, Nov. 22 (HealthDay News) -- The risk of acute kidney injury appears to be associated with both low values of estimated glomerular filtration rate (eGFR) and proteinuria, suggesting that both markers should be used to identify patients at risk for acute kidney injury, according to a study published online Nov. 22 in The Lancet.

Matthew T. James, M.D., of the University of Calgary in Canada, and colleagues evaluated a cohort of 920,985 adults not requiring chronic dialysis at baseline and with at least one outpatient measurement of both serum creatinine concentration and proteinuria, between 2002 and 2007.

The investigators found that 0.7 percent of participants were admitted to the hospital with acute kidney injury during a median follow-up of 35 months. Among patients with an eGFR of 60 mL/min/1.73 m² or greater, the adjusted risk of hospital admission with acute kidney injury was approximately four times higher in those with heavy proteinuria than those without proteinuria. For patients with all values of eGFR, the adjusted rates of admission with acute kidney injury and kidney injury needing dialysis remained high in participants with heavy dipstick proteinuria. Among participants admitted with acute kidney injury, the adjusted rates of death and the composite renal outcome were high, even though the rise associated with this injury was attenuated in those with low baseline eGFR and heavy proteinuria.

"These findings suggest that information on proteinuria and eGFR should be used together when identifying people at risk of acute kidney injury, and that an episode of acute kidney injury provides further long-term prognostic information in addition to eGFR and proteinuria," the authors write.

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