Abstract
Background Acute kidney injury (AKI) is frequent and associated with poor outcome in intensive care unit (ICU) patients. Besides the association with short- and long-term mortality, the increased risk of chronic kidney disease (CKD) has been recently highlighted in non-ICU patients. This study aims to describe the incidence and determinants of CKD after AKI and to develop a prediction score for CKD in ICU patients.Methods Prospective multicenter (n = 17) observational study included 1200 ICU patients who suffered from AKI (defined by an AKIN stage ≥ 1) during their ICU stay and were discharged alive from ICU. Preexisting end-stage renal disease (ESRD) and immunosuppressant treatments are the main exclusion criteria. Patients will be monitored by a nephrologist at day 90 and every year for 3 years. The main outcome is the occurrence of CKD defined by a creatinine-based estimated glomerular filtration rate (eGFR) lower than 60 mL/min/1.73 m2 or renal replacement therapy for ESRD in patients whose eGFR will be normalized (≥ 60 mL/min/1.73 m2) at day 90. Secondary outcomes include albuminuria changes, eGFR decline slope and ESRD risk in patients with preexisting CKD, cardiovascular and thromboembolic events and health-related quality of life.DiscussionThis is the first study prospectively investigating kidney function evolution in ICU patients who suffered from AKI. Albuminuria and eGFR monitoring will allow to identify ICU patients at risk of CKD who may benefit from close surveillance after recovering from AKI. Major patient and AKI-related determinants will be tested to develop a prediction score for CKD in this population.Trial registration ClinicalTrials.gov, NCT03282409. Registered on September 14, 2017
Highlights
Acute kidney injury (AKI) is frequent and associated with poor outcome in intensive care unit (ICU) patients
The PREDICT study is a multicenter observational prospective study aiming at describing the occurrence of chronic kidney disease (CKD) at 3 years in patients who suffered AKI during their ICU stay
It will be the first prospective study including a large sample of patients discharged alive from ICU able to provide CKD incidence after AKI in ICU and to highlight factors associated with CKD occurrence in this specific setting
Summary
Acute kidney injury (AKI) is frequent and associated with poor outcome in intensive care unit (ICU) patients. The prevalence of AKI in ICU patients has been estimated between 5 and 15% [1,2,3] It is strongly and independently associated with short- and long-term mortality [4]. While acute tubular necrosis is the most frequently reported cause of AKI in ICU patients, numerous pathological patterns have been observed in autopsy of kidneys in patients who died in the ICU following a septic shock [5]. This highlights the complexity of AKI in ICU, related to many harmful factors from ischemia–reperfusion lesions to sepsis-specific injuries. Endothelial dysfunction may be a worsening factor impacting long-term
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
