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Absence of long-term changes in urine biomarkers after AKI: findings from the CRIC study

Ian E McCoy1, Jesse Y Hsu2, Joseph V Bonventre3

  • 1Division of Nephrology, University of California San Francisco, Box 0532, 500 Parnassus Ave., MUW418, 94143-0532, San Francisco, CA, USA. ian.mccoy@ucsf.edu.

BMC Nephrology
|September 13, 2022
PubMed

Insights

Acute kidney injury (AKI) did not lead to lasting changes in urine biomarkers in adults with chronic kidney disease (CKD). These findings suggest urine biomarkers may not mediate AKI

Area of Science:

  • Nephrology
  • Biomarker Research
  • Clinical Medicine

Background:

  • The mechanisms linking acute kidney injury (AKI) to chronic kidney disease (CKD) progression are not fully understood.
  • Urine biomarkers are known predictors of CKD progression, but their long-term changes after AKI are unknown.
  • Investigating these changes could reveal if biomarkers mediate AKI's effect on CKD.

Purpose of the Study:

  • To determine if hospitalized AKI episodes cause long-term alterations in urine biomarkers in adults with CKD.
  • To assess whether these potential biomarker changes mediate the impact of AKI on CKD progression.

Main Methods:

  • The study analyzed 198 AKI hospitalizations in adult participants of the Chronic Renal Insufficiency Cohort (CRIC) Study.
  • Each AKI case was matched with a non-AKI hospitalization based on pre-hospitalization characteristics.
  • Urine samples collected before and after hospitalization were analyzed for specific biomarkers (e.g., KIM-1, MCP-1, YKL-40, EGF, UMOD, albumin).

Main Results:

  • No significant differences were observed in the post-hospitalization changes of urine biomarker-to-creatinine ratios between the AKI and non-AKI groups.
  • Specific biomarkers including KIM-1/Cr, MCP-1/Cr, YKL-40/Cr, EGF/Cr, UMOD/Cr, and albumin/Cr showed no significant long-term alterations attributable to AKI.
  • All p-values for biomarker changes were greater than 0.05, indicating no statistically significant impact of AKI.

Conclusions:

  • In adults with CKD, AKI was not associated with sustained long-term changes in the measured urine biomarkers.
  • These findings suggest that long-term alterations in these specific urine biomarkers may not be the mechanism through which AKI influences CKD progression.
Abstract

Keywords:
Acute kidney injuryBiomarkersChronic kidney disease

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