ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO002

The Association of Plasma Inflammatory Mediators with CKD and Mortality After AKI: The ASSESS-AKI Study

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Moledina, Dennis G., Yale School of Medicine, New Haven, Connecticut, United States
  • Parikh, Chirag R., Yale School of Medicine, New Haven, Connecticut, United States
  • Siew, Edward D., Vanderbilt University School of Medicine, Nashville, Tennessee, United States
  • Wurfel, Mark M., University of Washington, Seattle, Washington, United States
  • Kaufman, James S., VA New York Harbor Healthcare System, New York, New York, United States
  • Kimmel, Paul L., National Institute of Diabetes and Digestive Kidney Diseases (NIDDK), Bethesda, Maryland, United States
  • Go, Alan S., Kaiser Permanente Northern California, Oakland, California, United States
  • Tan, Thida C., Kaiser Permanente Northern California, Oakland, California, United States
  • Chinchilli, Vernon M., Penn State College of Medicine , Hershey, Pennsylvania, United States
  • Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Liu, Kathleen D., University of California at San Francisco School of Medicine, San Francisco, California, United States

Group or Team Name

  • ASSESS-AKI
Background

Inflammation contributes to development and progression of chronic kidney disease (CKD) after acute kidney injury (AKI) in preclinical studies. We evaluated the association of plasma inflammatory mediators with clinical outcomes in the longitudinal cohort of the ASSESS-AKI study

Methods

The ASSESS-AKI study is a multicenter, prospective cohort of participants hospitalized with AKI and matched non-AKI controls (n=769 pairs). We collected plasma samples collected during the index hospitalization and 3-months after discharge. We measured 10 inflammatory mediators [interferon (IFN)γ, tumor necrosis factor(TNF)α, interleukin (IL)1β, IL2, IL4, IL6, IL8, IL10, IL12p70, and IL13] using a MesoScale multiplex assay. We tested the independent association of these mediators with (a) chronic kidney disease (CKD) composite outcome, which included CKD incidence, progression, and end-stage kidney disease, and (b) death using a multivariable trivariate Weibull regression model

Results

The CKD composite outcome occurred in 297 (19%) participants and 309 (20%) died after 4.8 (3.4, 5.9) years of follow-up. Participants with AKI were more likely to experience CKD outcome than non-AKI participants [207 (27%) vs. 90 (12%)]. In a multivariable analysis controlling for eGFR, albuminuria, smoking, body mass index, and AKI status, TNF-α levels at both hospitalization and 3-months after discharge were associated with higher risk of CKD (Figure), whereas none of the other biomarkers were associated with CKD. At 3 months after hospital discharge, IL6 and IL8 levels were associated with an increased risk of death, which remained significant after controlling for C-reactive protein.

Conclusion

Among the plasma inflammatory biomarkers, TNFα levels measured during hospitalization and 3-months after discharge were independently associated with CKD, whereas IL6 and IL8 at 3-months after discharge were associated with increased mortality.

Funding

  • NIDDK Support