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Invited Commentary
February 14, 2011

The Acute Kidney Injury to Chronic Kidney Disease Continuum: Comment on “The Magnitude of Acute Serum Creatinine Increase After Cardiac Surgery and the Risk of Chronic Kidney Disease, Progression of Kidney Disease, and Death”

Neesh Pannu, MD, SM; Brenda Hemmelgarn, MD, PhD; Alberta Kidney Disease Network
Arch Intern Med. 2011;171(3):233-234. doi:10.1001/archinternmed.2010.515

The development of postoperative acute kidney injury (AKI) has been identified as the strongest risk factor for death in patients undergoing cardiac surgery.1 Patients requiring renal replacement therapy for postoperative AKI have mortality rates ranging from 40% to 80%, rates of similar magnitude as postoperative cardiac arrest and more striking than those of perioperative myocardial infarction or postoperative stroke or coma.1,2 The development of AKI represented by small and reversible changes in serum creatinine levels is also increasingly recognized as a marker of short-term mortality among patients undergoing cardiac surgery3,4; however, the clinical significance of these AKI episodes with respect to clinically relevant outcomes has not been well studied.

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