Proteinuria Raises Risk for Acute Kidney Injury

Acute kidney injury (AKI) raises risk for end-stage renal disease (ESRD) and renal-associated death. It often is iatrogenic (e.g., induced by drugs or contrast dye), and therefore often is preventable. Low estimated glomerular filtration rate (eGFR) predisposes patients to AKI, but the effect of proteinuria on risk for AKI has not been well characterized.

Researchers in Alberta, Canada, studied more than 900,000 adults without ESRD who underwent at least one outpatient measurement each of eGFR and proteinuria (by dipstick or albumin–creatinine ratio) from 2002 through 2006. Patients were stratified by baseline eGFR and proteinuria levels (normal, mild, or heavy) and were followed for a median of 35 months.

Within each eGFR stratum, patients w…