AKI - Risk of Progression to CKD

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Description

This collation will calculate a percentage risk of progression of acute kidney injury (AKI) to advanced chronic kidney disease (CKD).

AKI is defined by Kidney Disease-Improving Global Outcomes [KDIGO] criteria as an increase of 1.5 times the baseline serum creatinine observed in first 7 postoperative days OR when the baseline creatinine increases greater than or equal to 0.3 mg/dl in 48 hours after anesthesia end. Baseline serum creatinine is defined as the most recent serum creatinine resulted in the last 60 days preoperatively.

Risk of advanced CKD is defined as a risk of eGFR less than 30 mL/min/1.73 m2 for at least 3 months after discharge.

Risk of progression to advanced chronic kidney disease has been developed by an externally validated prediction model among hospital inpatients experiencing AKI, with all data available at the time of detection of acute kidney injury.

James MT, Pannu N, Hemmelgarn BR, et al. Derivation and External Validation of Prediction Models for Advanced Chronic Kidney Disease Following Acute Kidney Injury. JAMA. 2017;318(18):1787-1797.

Limitation

This phenotype has been specified for use in identifying AKI 01 failed cases that are at risk of developing chronic kidney disease. Should be used in conjunction with the AKI 01 measure phenotype or Complication- Acute Kidney Injury phenotype. Intended for use on adults >18 yo only If no AKI, will not calculate the risk of progression to CKD.

Data quality is limited to individual site documentation accuracy, completeness, and variable mapping, which is performed by each site, independently. MPOG, as the coordinating center, reviews data quality at each data upload and monthly via Data Diagnostics and Case Validation tools. This review, while thorough, may not contain all data elements relevant to this phenotype and thus should be carefully reviewed by the user.

Value Type

Numeric

Enumeration

Value	Value Code	Definition

Return Columns

Column Name	Data Type

Granularity

Logic

1. This collation depends on the results of the AKI 01 measure collation. Only those cases that result in a failed case (Stage 1, 2, or 3 AKI) should be assessed for this collation (AKI- Risk of Progression to CKD).

2. Use Model #3 from James et al. article to determine risk of progression to CKD (%):

Prediction model of CKD progression after AKI
	Model 3
Predictors	Age, sex, AKI stage,
Predictors	Baseline Scr
Intercept	-9.1857
Age (years)	0.0126
Sex (female)	1.0218
AKI (KDIGO definition)
Stage1
Stage2	0.7893
Stage3	1.9232
Baseline Scr (mg/dL)	3.7321

p=e^(-9.1857+0.0126*age+1.0218*sex+0.7893*AKI2+1.9232*AKI3+3.7321*BaselineSCr)/

(1+e^-9.1857+0.0126*age+1.0218*sex+0.7893*AKI2+1.9232*AKI3+3.7321*BaselineSCr)

where:

Age is continuous in years

Sex: male=0, female=1

Stage 1 AKI: AKI2=0 and AKI3=0

Stage 2 AKI: AKI2=1 and AKI3=0

Stage3 AKI: AKI2=0 and AKI3=1

Baseline Scr is continuous in mg/dL