Kidney Week

Abstract: FR-PO002

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

Session Information

• AKI: Clinical, Outcomes, Trials - I
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Moledina, Dennis G., Yale School of Medicine, New Haven, Connecticut, United States

Dennis G. Moledina,

• Parikh, Chirag R., Yale School of Medicine, New Haven, Connecticut, United States

Chirag R. Parikh,

• Siew, Edward D., Vanderbilt University School of Medicine, Nashville, Tennessee, United States

Edward D. Siew,

• Wurfel, Mark M., University of Washington, Seattle, Washington, United States

Mark M. Wurfel,

• Kaufman, James S., VA New York Harbor Healthcare System, New York, New York, United States

James S. Kaufman,

• Kimmel, Paul L., National Institute of Diabetes and Digestive Kidney Diseases (NIDDK), Bethesda, Maryland, United States

Paul L. Kimmel,

• Go, Alan S., Kaiser Permanente Northern California, Oakland, California, United States

Alan S. Go,

• Tan, Thida C., Kaiser Permanente Northern California, Oakland, California, United States

Thida C. Tan,

• Chinchilli, Vernon M., Penn State College of Medicine , Hershey, Pennsylvania, United States

Vernon M. Chinchilli,

• Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States

Steven G. Coca,

• Liu, Kathleen D., University of California at San Francisco School of Medicine, San Francisco, California, United States

Kathleen D. Liu,

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