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The desire to predict progression of posthospitalization kidney disease, particularly in patients who experienced acute kidney injury (AKI), led investigators to prospectively study a cohort of 769 hospitalized U.S. and Canadian patients (mean age, 65) with AKI whose mean prehospitalization serum creatinine level was 1.2 mg/dL. These patients were matched (on several key variables) with an equal number of patients without AKI. Albumin–creatinine ratio (ACR) was measured 3 months after hospitalization in all patients.
During a mean 4.7 years of follow-up, 97 AKI patients and 41 non-AKI patients developed chronic kidney disease (CKD). Higher ACR was associated most strongly with developing CKD. However, the association of ACR with subsequent C…