The ASsessment, Serial Evaluation, and Subsequent Sequelae in Acute Kidney Injury (ASSESS-AKI) Network

Overview

The ASsessment, Serial Evaluation, and Subsequent Sequelae in Acute Kidney Injury (ASSESS-AKI) Network is an epidemiological study of long term outcomes following episodes of AKI.  The AKI Network includes Clinical Research Centers at Kaiser Permanente of Northern California, Vanderbilt University - Validation of Acute Lung Injury Biomarkers for Diagnosis (VALID) Study, and Translational Research Investigating Biomarker End-Points (TRIBE) consortium (Yale University, University of Cincinnati, University of London, Ontario, McGill University, Montreal)  and a Data Coordinating Center at Penn State University.  The overall goals of ASSESS-AKI are to make significant contributions to the field of AKI in the five following areas:

  • Establishing a diverse prospective parallel, matched cohort of adults and children with and without AKI.
  • Characterizing the short-term and long-term natural history of AKI based on current serum creatinine-based criteria.
  • Evaluating the incremental utility of novel blood and urine biomarkers to refine the diagnosis and prognosis of AKI.
  • Developing a prognostic risk score that integrates patient characteristics and biomarkers to help inform providers and patients about the risks of adverse events after an episode of AKI.
  • Identifying the subset of high-risk patients with AKI who could be targeted for future interventional clinical trials to improve outcomes after an episode of AKI.

The ASSESS-AKI Study will address the following Specific Aims through the initiation and follow-up of a long-term prospective cohort of patients with and without evidence of AKI:

Primary Aims

  • Aim 1 — To determine whether persons who survive an episode of AKI have a greater risk of developing chronic kidney disease or faster progression of pre-existing chronic kidney disease than  hospitalized persons without AKI after accounting for pre-existing level of kidney function and potential confounders.
  • Aim 2 — To determine whether persons who suffer from an episode of AKI have a higher risk of death, cardiovascular events, and other adverse events after hospital discharge than matched persons who did not suffer AKI during hospitalization, after accounting for pre-existing level of kidney function and potential confounders.

Secondary Aims

  • Aim 3 — To evaluate the incremental value of serial measurements of several different blood and urine biomarkers for predicting short- and long-term clinical outcomes after an episode of AKI currently defined using a serum creatinine-based criteria.
  • Aim 4 — To assess whether severity and type of the AKI episode and the presence of pre-existing chronic kidney disease influence long-term risks of loss of kidney function, death, and cardiovascular events in persons with AKI.
  • Aim 5 — To determine if persons who completely recover kidney function within three months of an episode of AKI have a lower risk of adverse events than those persons with AKI whose recovery is incomplete.
  • Aim 6 — To develop a risk score incorporating demographic features, clinical factors, and/or biomarkers that accurately predicts outcomes after an episode of AKI.
Bio Profile

Chirag R Parikh, MD, PhD, FACP

Principal Investigator

Professor of Medicine (Nephrology)

Director, Program of Applied Translational Research

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Bio Profile

Steven Coca, DO, MS

Assistant Adjunct Professor, Internal Medicine, Nephrology

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Prasad Devarajan, MD

Cincinnati Children's Hospital Medical Center

Co-Investigator: Catherine Krawczeski, MD

Research Coordinator: Rachel Griffiths

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Amit Garg, MD, PhD

London Health Sciences Centre

Research Coordinators: Virginia Schumann, Laura Webster, Jodi Marshall

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Michael Zappitelli

Montreal Children's Hospital

Research Coordinator: Jessica Drolet

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ASSESS-AKI

Contact Information

For more information, or if you are interested in collaborating on this study, please contact patr@yale.edu

Project Funding

Funding for this project comes, in part, from the following grant:

U01DK082185 (NIH-NIDDK)

"Progression of Acute Kidney Injury to Chronic Kidney Disease"