FRIDAY, July 30 (HealthDay News) -- Protein in the urine (even at low levels) and decreased kidney function are independent warning signs of acute kidney injury (AKI), according to a study published online July 29 in the Journal of the American Society of Nephrology.

Morgan E. Grams, M.D., of the Johns Hopkins University in Baltimore, and colleagues studied a group of 11,200 subjects from the Atherosclerosis Risk in Communities study. The researchers followed the group for a mean of eight years for the incidence of AKI, and analyzed potential warning signs of impending AKI such as reduced estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio, as well as conventional risk factors such as age, race, and sex.

The researchers found that the risk of AKI, adjusted for age, gender, race, cardiovascular risk factors, and categories of eGFR, increased as the albumin-to-creatinine ratio increased. Based on a urine albumin-to-creatinine ratio of less than 10 mg/g (reference), the relative hazard ratios of AKI were 1.9 for an albumin-to-creatinine ratio of 11 to 29 mg/g, 2.2 for an albumin-to-creatinine ratio of 30 to 299 mg/g, and 4.8 for an albumin-to-creatinine ratio of 300 mg/g or greater. Likewise, the overall adjusted relative hazard of AKI rose as eGFR fell. The authors concluded that there are strong, independent associations between both albuminuria and eGFR and AKI.

"Patients with even low levels of albuminuria should be considered at increased risk for the development of AKI. As therapy for AKI prevention is refined, preventative measures extended to high-risk groups (e.g., older persons and those with more advanced chronic kidney disease) should also be considered for those with albuminuria," the authors write.

One study author is an employee of Merck and Company Inc.

Abstract
Full Text (subscription or payment may be required)