Abstract
This Practice Point commentary discusses the findings of a prospective observational study by Weisbord et al. that attempted to quantify the incidence and outcomes of contrast-induced acute kidney injury in patients with stage 3 chronic kidney disease (CKD). These data are set in the context of recent observations linking acute kidney injury with the progression of CKD to end-stage renal disease. The commentary also asks whether standard short-term clinical outcome measures—i.e. changes in serum creatinine—are adequate to assess the risk of disease progression in patients with mild-to-moderate CKD.
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References
Newsome BB et al. (2008) Long-term risk of mortality and end-stage renal disease among the elderly after small increases in serum creatinine level during hospitalization for acute myocardial infarction. Arch Intern Med 168: 609–616
Xue JL et al. (2006) Incidence and mortality of acute renal failure in Medicare beneficiaries, 1992 to 2001. J Am Soc Nephrol 17: 1135–1142
Lassnigg A et al. (2004) Minimal changes of serum creatinine predict prognosis in patients after cardiothoracic surgery: a prospective cohort study. J Am Soc Nephrol 15: 1597–1605
Thakar CV et al. (2005) A clinical score to predict acute renal failure after cardiac surgery. J Am Soc Nephrol 16: 162–168
Weisbord SD et al. (2008) Incidence and outcomes of contrast-induced AKI following computed tomography. Clin J Am Soc Nephrol [10.2215/CJN.01260308]
Basile DP et al. (2003) Chronic renal hypoxia after acute ischemic injury: effects of L-arginine on hypoxia and secondary damage. Am J Physiol Renal Physiol 284: F338–F348
Schmitt R and Cantley LG (2008) The impact of aging on kidney repair. Am J Physiol Renal Physiol 294: F1265–F1272
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Supplementary information
Supplementary Figure 1
Graph showing changes in serum creatinine level over time in a patient with progressive chronic kidney disease. The spikes indicate independent episodes of acute injury caused by specific clinical events, and are superimposed onto a gradual rise in serum creatinine that reflects the progression of chronic disease. This pattern is typical of patients with chronic kidney disease. (PPT 145 kb)
Supplementary Figure 2
Schematic representation of a proposed vicious cycle of mutual reinforcement between acute kidney injury and chronic kidney disease, leading to end-stage renal disease. Chronic kidney disease increases the risk of acute kidney injury, and acute kidney injury in turn accelerates progression of chronic kidney disease. (PPT 29 kb)
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Molitoris, B. Contrast nephropathy: are short-term outcome measures adequate for quantification of long-term renal risk?. Nat Rev Nephrol 4, 594–595 (2008). https://doi.org/10.1038/ncpneph0931
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DOI: https://doi.org/10.1038/ncpneph0931
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