Kidney Disease Research Updates
NIDDK Launches Multicenter Study to Provide Clearer Picture of Acute Kidney Injury
In December 2009, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) began enrolling patients for a multicenter study designed to characterize the short-term and long-term natural history of acute kidney injury (AKI). Three clinical centers and one data coordinating center are participating in the Assessment, Serial Evaluation, and Subsequent Sequelae in Acute Kidney Injury (ASSESS-AKI) trial, which is expected to report outcomes near the end of 2013.
AKI in hospitalized patients is a significant problem in the United States, ranging from 1 to 15 percent of hospitalized patients. Medical management of AKI has traditionally consisted of supportive care, with dialysis required for the most severe cases. Despite such interventions, mortality rates in AKI-affected patients remain high. In some studies, more than 50 percent of patients with AKI died within days or weeks of developing the condition.
Past studies have shown that patients who already have reduced kidney function, indicated by a glomerular filtration rate lower than 60 milliliters per minute, have an increased risk of developing AKI during hospitalization. Conversely, patients who have experienced an episode of AKI are more likely to develop chronic kidney disease and eventually end-stage renal disease months or years after the episode.
The ASSESS-AKI trial is establishing a diverse cohort of adults and children with AKI and matching it with a parallel cohort of adults and children without AKI. Researchers will use the traditional measures of kidney function based on serum creatinine to characterize the course of kidney impairment over the short and long term. Researchers will also evaluate novel biomarkers in blood and urine samples to refine the diagnosis and prognosis of AKI. Researchers expect to develop a prognostic risk score that integrates patient characteristics and biomarkers to help inform providers and patients about the risks of adverse events after an episode of AKI.
Paul Kimmel, M.D., director of the NIDDK’s Acute Kidney Injury Program, said, “Building a cohort of this size will create the first opportunity researchers have had to monitor the progression of kidney and cardiovascular disease over a 3 or more year period of time.”
The National Kidney and Urologic Diseases Information Clearinghouse, an information dissemination service of the NIDDK, has fact sheets and easy-to-read booklets about AKI and other kidney diseases. For more information and to obtain copies, visit www.kidney.niddk.nih.gov.
NIH Publication No. 10-4531