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Epidemiology and outcomes of post-AKI proteinuria

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单位： [1]Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China. [2]Guizhou Provincial People's Hospital, Guizhou University, Guiyang, China. [3]The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. [4]Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. [5]Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. [6]The Second People's Hospital of Shenzhen, Shenzhen University, Shenzhen, China. [7]Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, China. [8]Children's Hospital of Fudan University, Shanghai, China. [9]Renal Department and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Center for Kidney Diseases, Chengdu, China. [10]Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China. [11]Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [12]Department of Critical Care Medicine, Maoming People's Hospital, Maoming, China. [13]Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China. [14]Huizhou Municipal Central Hospital, Sun Yat-Sen University, Huizhou, China. [15]Department of Nephrology, the First People's Hospital of Foshan, Foshan, Guangdong, China. [16]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital, The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. [17]The Third Affiliated Hospital of Southern Medical University, Guangzhou, China. [18]Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. [19]Institute of Health Management, Southern Medical University, Guangzhou, China. [20]Digital China Health Technologies Corporation Limited, Beijing, China.

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关键词： adults epidemiology post-AKI proteinuria risk factor

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Acute kidney injury (AKI) has been associated with increased risks of new-onset and worsening proteinuria. However, epidemiologic data for post-AKI proteinuria was still lacking. This study aimed to determine the incidence, risk factors and clinical correlations of post-AKI proteinuria among hospitalized patients.This study was conducted in a multicenter cohort including patients aged 18-100 years with hospital-acquired AKI (HA-AKI) hospitalized at 19 medical centers throughout China. The primary outcome was the incidence of post-AKI proteinuria. Secondary outcomes included AKI recovery and kidney disease progression. The results of both quantitative and qualitative urinary protein tests were used to define post-AKI proteinuria. Cox proportional hazard model with stepwise regression was used to determine the risk factors for post-AKI proteinuria.Of 6206 HA-AKI patients without proteinuria at baseline, 2102 (33.9%) had new-onset proteinuria, whereas of 5137 HA-AKI with baseline proteinuria, 894 (17.4%) had worsening proteinuria after AKI. Higher AKI stage and preexisting CKD diagnosis were risk factors for new-onset proteinuria and worsening proteinuria, whereas treatment with renin-angiotensin system inhibitors was associated with an 11% lower risk of incident proteinuria. About 60% and 75% of patients with post-AKI new-onset and worsening proteinuria, respectively, recovered within 3 months. Worsening proteinuria was associated with a lower incidence of AKI recovery and a higher risk of kidney disease progression.Post-AKI proteinuria is common and usually transient among hospitalized patients. The risk profiles for new-onset and worsening post-AKI proteinuria differed markedly. Worsening proteinuria after AKI was associated with adverse kidney outcomes, which emphasized the need for close monitoring of proteinuria after AKI.© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.

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出版当年[2022]版：

大类 | 2 区医学

小类 | 2 区泌尿学与肾脏学

最新[2025]版：

大类 | 3 区医学

小类 | 3 区泌尿学与肾脏学

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第一作者单位： [1]Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China.

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Epidemiology and outcomes of post-AKI proteinuria

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