CINCINNATI — The University of Cincinnati College of Medicine has found that there are key health indicators that accurately predict recovery for patients who experience kidney failure due to acute kidney injury (AKI). Age, race, heart health and body mass are among the key factors.

AKI occurs when the kidneys stop working properly and can range from minor loss of kidney function to complete failure. 

These findings, published in the Clinical Kidney Journal, found that they can predict kidney recovery with 90 days and 12 months after the start of dialysis for kidney failure patients due to AKI. The study looked at the health outcomes of 22,922 patients from the U.S. Renal Data System from 2005 to 2014 to offer predictions.

“One of the significant comorbidities was a history of heart failure,” says Dr. Silvi Shah, associate professor in the Division of Nephrology at UC. “If you had heart failure, you were at a lower chance of recovering as well. If you had a lower body mass index, you had a lower chance of recovery; if you had amputation or poor functional status, you had a low chance of recovery. These were some of the significant predictors of the score.” 

Shah notes that younger people got more points in the prediction model because older age was also associated with a likelihood of lower recovery for kidney failure patients due to AKI. 

“That was our broad approach. If your score is high, you have the best chance of recovery,” says Dr. Charachas Thakar. “Patients who are more likely to recover can be monitored closely for that prospect and we can focus our energies on preserving renal function. At the same time, those who are unlikely to recover should be allowed to undergo long-term planning including transplantation. In summary, our study paves the way to individualize care as well as facilitate efficient use of treatment and resources.”

The United States Renal Data System captures all patients on dialysis in this country. 

“One of the biggest strengths of the paper was that it was inclusive, and the score was individualized,” Shah says. “It can help in counseling and risk prediction and tailoring treatment specifically for patients that have dialysis-dependent AKI, and based on the score, we can tell patients what’s the chance of their recovery.”

Other co-authors of the research at the University of Cincinnati are Department of Environmental and Public Health Sciences professors Anthony Leonard, Karthikeyan Meganathan and Annette Christianson, along with Kathleen Harrison from the Division of Nephrology. Dr. Jia Ng, assistant professor of medicine at Hofstra University, is also a co-author of the study.