Change search
ReferencesLink to record
Permanent link

Direct link
A meta-analysis of the association of estimated GFR, albuminuria, age, race, and sex with acute kidney injury
Show others and affiliations
Number of Authors: 14
2015 (English)In: American Journal of Kidney Diseases, ISSN 0272-6386, E-ISSN 1523-6838, Vol. 66, no 4, 591-601 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Acute kidney injury (AKI) is a serious global public health problem. We aimed to quantify the risk of AKI associated with estimated glomerular filtration rate (eGFR), albuminuria (albumin-creatinine ratio [ACR]), age, sex, and race (African American and white).

STUDY DESIGN: Collaborative meta-analysis.

SETTING & POPULATION: 8 general-population cohorts (1,285,049 participants) and 5 chronic kidney disease (CKD) cohorts (79,519 participants).

SELECTION CRITERIA FOR STUDIES: Available eGFR, ACR, and 50 or more AKI events.

PREDICTORS: Age, sex, race, eGFR, urine ACR, and interactions.

OUTCOME: Hospitalized with or for AKI, using Cox proportional hazards models to estimate HRs of AKI and random-effects meta-analysis to pool results.

RESULTS: 16,480 (1.3%) general-population cohort participants had AKI over a mean follow-up of 4 years; 2,087 (2.6%) CKD participants had AKI over a mean follow-up of 1 year. Lower eGFR and higher ACR were strongly associated with AKI. Compared with eGFR of 80mL/min/1.73m(2), the adjusted HR of AKI at eGFR of 45mL/min/1.73m(2) was 3.35 (95% CI, 2.75-4.07). Compared with ACR of 5mg/g, the risk of AKI at ACR of 300mg/g was 2.73 (95% CI, 2.18-3.43). Older age was associated with higher risk of AKI, but this effect was attenuated with lower eGFR or higher ACR. Male sex was associated with higher risk of AKI, with a slight attenuation in lower eGFR but not in higher ACR. African Americans had higher AKI risk at higher levels of eGFR and most levels of ACR.

LIMITATIONS: Only 2 general-population cohorts could contribute to analyses by race; AKI identified by diagnostic code.

CONCLUSIONS: Reduced eGFR and increased ACR are consistent strong risk factors for AKI, whereas associations of AKI with age, sex, and race may be weaker in more advanced stages of CKD.

Place, publisher, year, edition, pages
2015. Vol. 66, no 4, 591-601 p.
Keyword [en]
estimated glomerular filtration rate (eGFR); renal function; albuminuria; albumin-creatinine ratio (ACR); proteinuria; age; race/ethnicity; sex; acute kidney injury (AKI); acute renal failure (ARF); Chronic Kidney Disease Prognosis Consortium; meta-analysis
National Category
Clinical Medicine
Research subject
Health and Welfare
URN: urn:nbn:se:du-20442DOI: 10.1053/j.ajkd.2015.02.337PubMedID: 25943717OAI: oai:DiVA.org:du-20442DiVA: diva2:883505
Available from: 2015-12-17 Created: 2015-12-17 Last updated: 2016-09-27Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Ärnlöv, Johan
By organisation
Medical Science
In the same journal
American Journal of Kidney Diseases
Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 291 hits
ReferencesLink to record
Permanent link

Direct link