Harmonization of epidemiology of acute kidney injury and acute kidney disease produces comparable findings across four geographic populations.

Simon Sawhney, Samira Bell, Corri Black, Christian Fynbo Christiansen, Uffe Heide-Jørgensen, Simon Kok Jensen, Paul E. Ronksley, Zhi Tan, Marcello Tonelli, Heather Mhairi Walker, Matthew T James* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
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There is substantial variability in the reported incidence and outcomes of acute kidney injury (AKI). The extent to which this is attributable to differences in source populations versus methodological differences between studies is uncertain. We used 4 population-based datasets from Canada, Denmark, and the United Kingdom to measure the annual incidence and prognosis of AKI and acute kidney disease (AKD), using a homogenous analytical approach that incorporated KDIGO creatininebased definitions and subsets of the AKI/AKD criteria. The cohorts included 7 million adults ≥18 years of age between 2011 and 2014; median age 59-68 years, 51.9-54.4% female sex. Age- and sexstandardised incidence rates for AKI or AKD were similar between regions and years; range 134.3-162.4 events/10,000 person years. Among patients who met either KDIGO 48 hour or 7-day AKI creatinine criteria, the standardised 1-year mortality was similar (30.4-38.5%) across the cohorts, which was comparable to standardised 1-year mortality among patients who met AKI/AKD criteria
using a baseline creatinine within 8-90 days prior (32.0-37.4%). Standardised 1-year mortality was lower (21.0-25.5% across cohorts) among patients with AKI/AKD ascertained using a baseline creatinine >90 days prior. These findings illustrate that the incidence and prognosis of AKI and AKD based on KDIGO criteria are consistent across 3 high-income countries when capture of laboratory tests is complete, creatinine-based definitions are implemented consistently within but not beyond a 90-day period, and adjustment is made for population age and sex. These approaches should be consistently applied to improve the generalizability and comparability of AKI research and clinical
Original languageEnglish
Pages (from-to)1271-1281
Number of pages11
JournalKidney International
Issue number6
Early online date18 May 2022
Publication statusPublished - Jun 2022

Bibliographical note

We acknowledge the support of the Grampian Data Safe Haven (DaSH) facility within the Aberdeen Centre for Health Data Science and the associated financial support of the University of Aberdeen, and NHS Research Scotland (through NHS Grampian investment in DaSH). For more information, visit the DaSH website: http://www.abdn.ac.uk/iahs/facilities/grampian-data-safe-haven.php
Dr Sawhney is supported by a Starter Grant for Clinical Lecturers from the Academy of Medical Sciences, Wellcome Trust, Medical Research Council, British Heart Foundation, Arthritis Research UK, the Royal College of Physicians and Diabetes UK [SGL020\1076]. Drs James and Tonelli are supported by Canadian Institutes of Health Research Foundation Grants.
Dr Black is supported by Health Data Research UK, which is funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division
(Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and the Wellcome Trust.


  • acute kidney injury
  • chronic kidney disease


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