Transitioning from acute kidney injury (AKI) to chronic kidney disease (CKD) is associated with an increased long-term risk for infection, according to investigators.
In a Spanish study, patients who experienced this transition had a significant 1.5-fold increased long-term risk for infection following an episode of AKI, Ana Sánchez Horrillo, MD, of Hospital Universitario de La Princesa in Madrid, Spain, and colleagues reported in the Clinical Kidney Journal.
“Our results demonstrate for the first time a predictive association of the AKI-to-CKD transition with the risk of infection,” the authors wrote.
Dr Horrillo and colleagues retrospectively studied 367 patients hospitalized with community-acquired AKI. Of these, 159 (43%) experienced transition from AKI to CKD, defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2 at 3 months.
During a median follow-up period of 9 months, infection developed in 153 (42%) of the 367 patients. The most common infections were those of the urinary tract (44%), respiratory tract (30%), soft tissue (9%), and abdomen (9%).
Both baseline and post-AKI eGFR independently predicted transition to CKD. Each 1 mL/min/1.73 m2 increase in baseline eGFR and post-AKI eGFR was significantly associated with a 22% and 30% decreased risk for transition from AKI to CKD, respectively, according to investigators.
Although several mechanisms could explain the elevated risk for infection, the exact pathophysiology remains unclear, the authors noted.
The investigators concluded that “efforts must be directed to preserve renal function after AKI episodes to avoid the adverse consequences of persistent kidney dysfunction.”
Horrillo AS, Villaneuva LS, Cárdenas AC, Ramos PM, Ortiz A, Quiroga B. Infectious consequences of the AKI-to-CKD transition. Clin Kidney J. Published online July 30, 2022. doi:10.1093/ckj/sfac178