#3610 EPIDEMIOLOGY AND CLINICAL CORRELATES OF POST-AKI PROTEINURIA IN CHINESE HOSPITALIZED ADULTS

Abstract

Abstract Background and Aims Acute kidney injury (AKI) has been associated with increased risks of new-onset and worsening proteinuria. However, the epidemiologic data of post-AKI proteinuria was still lacking. This study aimed to determine the incidence, risk factors and clinical correlations of post-AKI proteinuria among hospitalized patients. Method This study conducted a multicenter cohort from Chinese Renal disease Data System (CRDS), including patients aged 18–100 years with hospital-acquired AKI (HA-AKI) hospitalized at 19 medical centers throughout China. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) creatine criteria. The results of both quantitative and qualitative urinary protein tests were used to determine post-AKI proteinuria. The primary outcome was the incidence of post-AKI proteinuria. Secondary outcomes included AKI recovery and kidney disease progression. Cox proportional hazard model with stepwise regression was used to determine the risk factors for post-AKI proteinuria. The associations of post-AKI proteinuria with kidney disease progression were analyzed by logistic regression models. Results Of 6,206 HA-AKI patients without proteinuria at baseline, 2,102 (33.9%) had new-onset proteinuria, whereas, of 5,137 HA-AKI with baseline proteinuria, 894 (17.4%) had worsening proteinuria after AKI (Table 1). Higher AKI stage and preexisting CKD diagnosis were risk factors for new-onset proteinuria and worsening proteinuria, whereas treatment with RAS inhibitors was associated with an 11% lower risk of incident proteinuria. About 60% and 75% of patients with post-AKI new-onset and worsening proteinuria, respectively, recovered within 3 months. Worsening proteinuria was associated with a lower incidence of AKI recovery and a higher risk of kidney disease progression (Table 2). Conclusion Post-AKI proteinuria is common and usually transient among hospitalized patients. The risk profiles for new-onset and worsening post-AKI proteinuria differed markedly. Worsening proteinuria after AKI was associated with adverse kidney outcomes, which emphasized the need for close monitoring of proteinuria after AKI.