Transition from acute kidney injury to chronic kidney disease: a single-centre cohort study

  • Yutaka Hatakeyama
  • Taro Horino
  • Keitaro Nagata
  • Tatsuki Matsumoto
  • Yoshio Terada
  • Yoshiyasu Okuhara
Original article



The incidence of acute kidney injury (AKI) is increasing. AKI is currently recognised as an inducer of chronic kidney disease (CKD) and this is known as the ‘AKI–CKD transition’. This study aimed to evaluate the rate of decline in estimated glomerular filtration rate (eGFR) associated with AKI events in individuals with and without pre-existing CKD.


Inpatients aged 18–80 years were retrospectively enrolled. AKI was diagnosed according to the kidney disease improving global outcomes (KDIGO) criteria using serum creatinine levels. Patients with a history of AKI events were divided into four groups according to eGFR before and after the AKI events. In each group, the eGFR levels after an AKI event were compared to those before the AKI event. Patients were further divided into eight groups according to clinical background based on underlying diseases, medications, and surgical history.


We analysed data from 9651 patients with AKI. Not surprisingly, we found that eGFR levels during the first AKI event were significantly lower than levels before the event in each group. Furthermore, eGFR levels after the first AKI event were significantly lower than those before the first AKI event, and the eGFR levels after the second AKI event were significantly lower than those after the first AKI event. These trends were similar in each group irrespective of clinical background.


Our study revealed that AKI events can cause a decline in kidney function and, as more AKI events occur, acceleration of this decline.


Acute kidney injury (AKI) AKI–CKD transition KDIGO Chronic kidney disease (CKD) Medical database 



This work was supported by The Kidney Foundation Japan and Kochi Organization for Medical Reformation and Renewal (to YT) and by a Grant from the Ministry of Education, Science, Culture, and Sports of Japan (to YT and YO).

Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number 23-15) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  1. 1.Center of Medical Information Science, Kochi Medical SchoolKochi UniversityNankokuJapan
  2. 2.Department of Endocrinology, Metabolism and Nephrology, Kochi Medical SchoolKochi UniversityNankokuJapan

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