Matthew T James MD, PhDAssistant ProfessorUniversity of Calgary

Integrated Approach to Laboratory Measurements to Identify Acute Kidney Diseases Interview with:

Matthew T James MD, PhDAssistant ProfessorUniversity of Calgary

Dr. James

Matthew T James MD, PhD
Assistant Professor
University of Calgary What is the background for this study? What are the main findings? 

Response: The Acute Kidney Disease and Disorders (AKD) criteria from the KDIGO Acute Kidney Injury guidelines identified many patients who do not meet existing criteria for Chronic Kidney Disease or Acute Kidney Injury (AKI), and the majority of AKD events occured in the community rather than hospital setting.

This study characterized the frequency and outcome for patients with AKD (without  AKI) as well as AKD with CKD from among over 1.1 million adults  residing in Alberta Canada who received  kidney function testing and were followed for up to 8 years. What should readers take away from your report?

Response: AKD without Acute Kidney Injury  was relatively common (seen in 3.8 patients per 100 tested) while AKD with DKD was also seen in a further 0.6 per 100 patients tested.

Adding the criteria for AKD identified many patients who did not meet the current criteria for CKD or AKI.

AKD w/o AKI was associated with higher risks of developing new CKD, progression of pre-existing CKD, developing End-Stage Kidney Disease, and Death, compared to having no kidney disease. What recommendations do you have for future research as a result of this work?

 Response: These findings suggest that incorporation of Acute Kidney Disease into clinical and research initiatives for kidney disease could increase recognition of patients at risk of adverse outcomes currently not identified by AKI and CKD criteria. However, it should be recognized that the clinical  characteristics and additional value of  recognizing AKD remains to be determined.



James MT, Levey AS, Tonelli M, et al. Incidence and Prognosis of Acute Kidney Diseases and Disorders Using an Integrated Approach to Laboratory Measurements in a Universal Health Care System. JAMA Netw Open.2019;2(4):e191795. doi:10.1001/jamanetworkopen.2019.1795 

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Last Updated on April 8, 2019 by Marie Benz MD FAAD