Title: Relationship between acute and chronic kidney disease using VA national data
Presenter: Richard Amdur, PhD
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Abstract: Until recently, it was thought that patients who survived an episode of acute kidney injury (AKI) and returned to a normal kidney functioning (as measured by serum creatinine) would have little or no chronic kidney problems as a result. By examining large longitudinal patient samples, we and other VA researchers showed that this was not the case. We developed and validated prediction models to identify AKI patients at high risk for progression to chronic kidney disease (CKD) and end-stage renal failure (ESRD). We also showed that episodes of AKI raised the risk of later cardiovascular disease events (MI, stroke, death). Finally, we proposed a method for measuring variability in kidney functioning that was mathematically independent of slope of CKD progression, and that was a powerful predictor of CKD progression, even in initially healthy patients. Overall, our work and that of other VA researcher over the past 10 years has helped to inform a new understanding of the complex inter-relationship between AKI and CKD.