Kidney Week 2025 Annual Meeting-AKI Everywhere All at Once: Risks, Trajectories, and Practice Patterns

Video Transcription

Video Summary

The session “AKI Everywhere, All at Once: Risks, Trajectories, and Practice Patterns” featured trainee and faculty research on diverse acute kidney injury (AKI) risk factors, prediction, and care patterns.<br /><br />A UK Biobank study reported that sarcopenia (probable/confirmed) and phenotypic age acceleration (phenoAgeAccel) were each independently associated with higher new-onset AKI risk, with evidence of additive interaction at the highest biological-aging quartile. Discussion highlighted creatinine’s dependence on muscle mass and potential AKI underestimation in sarcopenic patients.<br /><br />Using a large U.S. EHR network, investigators found metabolic-associated steatotic liver disease/steatohepatitis (MASLD/MASH) to be an independent risk factor for CKD, proteinuria, and AKI (AKI odds ratio ~2.16) even after excluding diabetes and hypertension, though ICD-code limitations prevented granular AKI cause/severity analyses.<br /><br />A Texas-based study linked higher ambient temperatures and cooling degree days with increased AKI-associated hospital admissions, proposing a scalable, administrative-code methodology to monitor heat-wave kidney impacts.<br /><br />A prospective ACS/PCI study used PBMC gene expression and machine learning to predict post-PCI renal function trajectories. Immune-related signatures (e.g., B-cell signaling) distinguished AKI and “abnormal renal function,” with high AUCs, suggesting potential rapid PCR-based risk tools.<br /><br />A reinforcement-learning “Kidney Pilot” model recommended hemodynamic/medication strategies after cardiac surgery and, via off-policy and concordance analyses, was associated with lower persistent AKI rates, warranting clinical trials.<br /><br />National Inpatient Sample data (2018–2021) showed rising CRRT use among dialysis-requiring AKI, very high in-hospital mortality (~60%), longer stays, and markedly higher charges.<br /><br />VA data revealed wide facility variation in ACEi/ARB discontinuation during AKI (≈30–70%); holding therapy strongly reduced 6‑month use.<br /><br />Cystatin C at 3 months post-AKI revealed greater creatinine-based recovery misclassification and undetected CKD in females.<br /><br />Finally, a Mayo OB cohort found pregnancy-related AKI incidence ~1.15%, associated with comorbidities, cesarean delivery, nephrotoxin/NSAID exposure, and worse neonatal outcomes; most recovered, but ~2% had persistent dysfunction.

Asset Subtitle

Moderator(s): Javier Neyra, Gurmukteshwar Singh

Presentation(s):

Associations Between Sarcopenia, PhenoAgeAccel, and New-Onset AKI: A UK Biobank Study - Zhangzhe Peng
Metabolic Dysfunction-Associated Steatotic Liver Disease Is Associated with Kidney Dysfunction Independent of Diabetes and Hypertension: A Real-World Cohort Study Using TriNetX - Shori Gerardot
Relationship Between Environmental Temperature and Hospital Admissions for AKI from a US Electronic Health Records Database - Sarah Dixon Stump
Gene Signatures Predicting Kidney Function Trajectories After Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome - Diangeng Li
KidneyPilot: Reinforcement Learning Model for Prevention of Persistent AKI After Cardiac Surgery - Moein Sabounchi
CRRT Utilization Trends and Economic Impact in AKI Patients Requiring Renal Replacement Therapy: A Nationwide Analysis - Benjamin Bizer
Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers During AKI Varies Substantially by Treatment Facility - Benjamin Griffin
Cystatin C Reveals Sex Differences in Misclassified Kidney Recovery and Undetected CKD Among AKI Survivors in ASSESS-AKI - Bethany Birkelo
Etiologies and Outcomes of Pregnancy-Related AKI in a US Quaternary Obstetric Population: A Retrospective Cohort Study - Mehdi Kashani

Note: Continuing education credits are not being offered for this session.

Meta Tag

Date 11/7/2025

Pathway 1 AKI and Critical Care

Session ID 519805

Keywords

acute kidney injury (AKI)

AKI risk factors

UK Biobank

sarcopenia

phenotypic age acceleration (phenoAgeAccel)

metabolic-associated steatotic liver disease (MASLD/MASH)

electronic health records (EHR)

ambient temperature and heat waves

machine learning prediction

PBMC gene expression biomarkers

reinforcement learning Kidney Pilot model

continuous renal replacement therapy (CRRT) outcomes

ACEi/ARB discontinuation during AKI