Volume 92, Issue 2, Pages (August 2017)

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Volume 92, Issue 2, Pages 440-452 (August 2017) Post-discharge kidney function is associated with subsequent ten-year renal progression risk among survivors of acute kidney injury Simon Sawhney, Angharad Marks, Nick Fluck, Adeera Levin, David McLernon, Gordon Prescott, Corri Black Kidney International Volume 92, Issue 2, Pages 440-452 (August 2017) DOI: 10.1016/j.kint.2017.02.019 Copyright © 2017 International Society of Nephrology Terms and Conditions

Figure 1 Renal progression after acute kidney injury (AKI) caused by renal decline (red solid line) or nonrecovery (pink dashed line). A patient with AKI who has incomplete post-episode recovery has a high risk of developing advanced chronic kidney disease (CKD) even if subsequent renal decline is slow (pink dashed line). However, the risk of advanced CKD in a patient with AKI who has near-complete recovery depends on whether he or she experiences subsequent decline at a rapid trajectory (red solid line). In both cases at a post-AKI reassessment review (time d), renal recovery and post-episode kidney function are already observable, but the risk of subsequent decline is uncertain. The vertical black dashed line at time d represents the start of follow-up in this study. eGFR, estimated glomerular filtration rate. Kidney International 2017 92, 440-452DOI: (10.1016/j.kint.2017.02.019) Copyright © 2017 International Society of Nephrology Terms and Conditions

Figure 2 Flow diagram showing derivation of the cohort from the Grampian population. AKI, acute kidney injury; RRT, renal replacement therapy. Kidney International 2017 92, 440-452DOI: (10.1016/j.kint.2017.02.019) Copyright © 2017 International Society of Nephrology Terms and Conditions

Figure 3 Crude long-term renal outcomes after a hospital admission episode with or without acute kidney injury (AKI). CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate. Kidney International 2017 92, 440-452DOI: (10.1016/j.kint.2017.02.019) Copyright © 2017 International Society of Nephrology Terms and Conditions

Figure 4 Cumulative incidences of subsequent renal progression (solid line) for those with (red) and without (blue) an acute kidney injury (AKI) admission in 2003, grouped by postdischarge estimated glomerular rate (eGFR) and accounting for the competing risk of death (dashed line). (a,b) Subsequent sustained 30% renal decline; (c,d) new chronic kidney disease (CKD) stage 4. Kidney International 2017 92, 440-452DOI: (10.1016/j.kint.2017.02.019) Copyright © 2017 International Society of Nephrology Terms and Conditions