Acute kidney disease after acute kidney injury: incidence, risk factors, and association with de novo chronic kidney disease.
- 1Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Abstract
Acute Kidney Disease (AKD) is defined as acute kidney injury (AKI) persisting for 7 to 90 days and represents a window for interventions to improve renal outcomes. However, data on AKD remain underexplored. This retrospective cohort study at Tongji Hospital, China, included 23,868 adult patients who survived at least one AKI episode between January 2015 and April 2024. Using electronic medical record data, we aimed to quantify the incidence of AKD among AKI survivors, identify independent risk factors, and evaluate the association between AKD and de novo chronic kidney disease (CKD). Among the cohort, 10,884 patients (45.6%) progressed to AKD. Multivariable logistic regression revealed that advanced age, preexisting hypertension, heart failure, cirrhosis, recent diuretic use, hepatorenal syndrome, higher baseline estimated glomerular filtration rate, higher AKI stage, and dialysis-requiring AKI were independent risk factors for AKD. Fine-Gray competing-risk analysis accounting for acute-phase mortality confirmed that higher AKI severity was independently associated with AKD progression. In a subcohort of 6597 patients without preexisting CKD who had at least one year of follow-up, 19.8% developed de novo CKD. Cox proportional hazards analysis demonstrated that patients with AKD had a significantly increased risk of de novo CKD compared to those without AKD (HR 1.92, 95% CI 1.70-2.17). These findings highlight the high proportion of AKD among patients with AKI, and emphasize the importance of early detection and targeted management for high-risk groups. It is critical to strengthen post-discharge renal function monitoring and intervention strategies for AKI patients to improve long-term renal outcomes.
Related
- Functional organization of multimorbidity links chronic disease incidence to shared genetic architecture
- Serum Uric Acid and Disease Severity in Chronic Liver Disease: A Cross-Sectional Study of Its Association With Child-Pugh Class
- Factors associated with chronic kidney disease stage among patients with uncontrolled diabetes and/or hypertension in Northeastern Thailand: a cross-sectional study
- The association between parenting a child with a chronic disease and mental disorders: a case-control study
- Association of Serum Galectin-3 with Aortic Stiffness in Adults with Stage 3–5 Non-Dialysis Chronic Kidney Disease: Overall and Stage-Stratified Analyses
BibTeX
@article{hu2026acute,
title = {{Acute kidney disease after acute kidney injury: incidence, risk factors, and association with de novo chronic kidney disease.}},
author = {Sujia Hu and Xingyang Zhao and Yichun Cheng and Shuwang Ge},
journal = {Renal failure},
year = {2026},
month = oct,
doi = {10.1080/0886022x.2026.2745291},
url = {https://europepmc.org/article/MED/42876246},
note = {CC BY},
}
RIS
TY - JOUR
TI - Acute kidney disease after acute kidney injury: incidence, risk factors, and association with de novo chronic kidney disease.
AU - Sujia Hu
AU - Xingyang Zhao
AU - Yichun Cheng
AU - Shuwang Ge
PY - 2026
DA - 2026/10/15
JO - Renal failure
DO - 10.1080/0886022x.2026.2745291
UR - https://europepmc.org/article/MED/42876246
AB - Acute Kidney Disease (AKD) is defined as acute kidney injury (AKI) persisting for 7 to 90 days and represents a window for interventions to improve renal outcomes. However, data on AKD remain underexplored. This retrospective cohort study at Tongji Hospital, China, included 23,868 adult patients who survived at least one AKI episode between January 2015 and April 2024. Using electronic medical record data, we aimed to quantify the incidence of AKD among AKI survivors, identify independent risk factors, and evaluate the association between AKD and de novo chronic kidney disease (CKD). Among the cohort, 10,884 patients (45.6%) progressed to AKD. Multivariable logistic regression revealed that advanced age, preexisting hypertension, heart failure, cirrhosis, recent diuretic use, hepatorenal syndrome, higher baseline estimated glomerular filtration rate, higher AKI stage, and dialysis-requiring AKI were independent risk factors for AKD. Fine-Gray competing-risk analysis accounting for acute-phase mortality confirmed that higher AKI severity was independently associated with AKD progression. In a subcohort of 6597 patients without preexisting CKD who had at least one year of follow-up, 19.8% developed de novo CKD. Cox proportional hazards analysis demonstrated that patients with AKD had a significantly increased risk of de novo CKD compared to those without AKD (HR 1.92, 95% CI 1.70-2.17). These findings highlight the high proportion of AKD among patients with AKI, and emphasize the importance of early detection and targeted management for high-risk groups. It is critical to strengthen post-discharge renal function monitoring and intervention strategies for AKI patients to improve long-term renal outcomes.
SN - 0886-022X
SN - 1525-6049
ER -