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Long-term kidney and heart outcomes after acute kidney injury among newborns and children

Dr. Rahul Chanchlani
McMaster University
Biomedical Research Grant
2019 - 2021
Renal Failure
Lay Summary
Acute kidney injury (AKI) is sudden damage to the kidneys that causes them to not work properly. It occurs in one in five and one in three hospitalized adults and children, respectively. If the kidneys shut down completely, this may require temporary support in form of dialysis until the kidney function recovers. Occasionally, AKI causes loss of kidney function or chronic kidney disease (CKD), hypertension, and death.
Recently, in adults, AKI has been shown to cause a 9-fold risk of CKD and a 2-fold risk of death compared to those individuals without AKI. However, there is a limited understanding of the risk of these complications after AKI among newborns and children. Most of the studies in this population done so far have been of variable quality, with short follow-up and small sample size. There is also a lack of information on how much the health care costs are increased after AKI and whether rates of AKI have increased among newborns and children in Ontario over the last 20 years.
Dr. Chanchlani will determine how often newborns and children with AKI develop CKD and hypertension compared to those without AKI in Ontario. He will compare the risk of permanent kidney damage (end-stage kidney disease) and death in newborns and children with AKI compared to those without AKI. He will also determine the increased costs of healthcare in 1, 5, and 10 years after the development of AKI and whether or not AKI rates have increased in Ontario over the last 20 years among newborns and children.
Currently, doctors cannot provide information on the future risk of kidney and heart problems to the families, and there is no follow-up policy on such patients. The study results will help identify which newborns and children are more likely to develop CKD and hypertension after AKI so that they can be seen by doctors regularly to improve their kidney and heart health.