Table 1.

Summary of knowledge gaps in current understanding of the long-term outcomes of AKI

Areas of Uncertainty/Knowledge Gaps in Our Understanding of the Long-Term Outcomes of AKISuggestions for Next Steps
To what degree the association between AKI and mortality is causalProspective data collection with adequate consideration of confounding variables, intervention studies that demonstrate reduced mortality
Understanding of the mechanism of the link between AKI and CKD in humansTranslation of animal models to humans; clinical studies incorporating methods that improve mechanistic understanding of the AKI to CKD transition in humans (e.g., biopsy, biomarkers, or imaging)
Incorporation of etiologic factors into assessment and definition of AKIDevelopment of tools that include AKI etiology in assessment; prospective data collection focusing on precise etiology of AKI
Optimal measurement of kidney function following AKIConsensus definition to allow for harmonization of data going forward
Understanding the incidence of albuminuria post-AKI because this might be a potential target for future interventionIncorporation of albuminuria into CKD definition post-AKI in line with the KDIGO CKD definition; further study of albuminuria as an independent risk factor for adverse outcomes in a post-AKI setting
Establish the role of existing or novel biomarkers in the recovery phase of AKI to improve risk stratification and/or provide mechanistic insights into the AKI to CKD transitionCollection of biomarkers at time of AKI combined with collection of biomarkers during recovery
Availability of interventions that reduce long-term sequelae following AKIStudies into optimal or tailored follow-up strategies and research into gaps in current post-AKI care
  • KDIGO, Kidney Disease Improving Global Outcomes.