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Kidney International (2012) 81             423

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Kidney International (2012) 81, 423. doi:10.1038/ki.2011.486

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Chronic kidney 
disease following 
acute kidney injury

Tradit iona l t houg ht has held t hat 
acute kidney injury (AKI) is revers-
ible. However, as the population ages, 
and patients with more serious dis-
eases survive, the issue of whether AKI 
actually leads to de novo chronic kid-
ney disease (CKD) has emerged as an 
important epidemiological question. 
As they report in this issue, Bucaloiu et 
al. examined the records from a single 
hospital and found that of those patients 
who were discharged and alive 3 months 
later, 1610 had AKI that resolved. A 
cohort of 3652 formed the control group 

and had no AKI. Follow-up of these two 
groups of patients for more than 3 years 
showed that the risk of death associated 
with reversible AKI was significant. 
Reversible AKI was associated with a 
significant risk of de novo CKD. These 
studies demonstrate that patients who 
develop AKI need to be followed up for 
appearance of CKD. See page 477.

Hyperfiltration  
and progression  
in diabetes
To investigate the consequences of 
hyperfiltration in diabetes, Moriya et al. 
studied 30 patients with type 2 diabe-
tes. They measured glomerular filtration 
rate (GFR), by the iohexol clearance, 
and estimated the filtration surface in 
glomeruli determined by renal biopsy 
and morphometr y. They found that 
GFR correlated with only the filtration 
surface area among other morpho-
logical measurements. The filtration 
area was positively correlated with the 
decrease in GFR in the first year of fol-
low-up but not later. GFR decreased in 

nine of the 30 patients followed, while 
in 11 patients, there was no change in 
GFR. Those that had hyperfiltration 
were more likely to have a subsequent 
decline in GFR. See page 486.

Uric acid and  
blood pressure

There is increasing evidence for the 
association of uric acid levels and 
hypertension. Parsa et al. studied the 
relationship between blood pressure 
and single-nucleotide polymorphisms 
of GLUT9, a uric acid transporter, in an 
Amish community. All subjects were 
untreated and were placed on known 
diets with high or low salt intake. The 
investigators found that each copy of the 
GLUT9 minor Ile allele conferred a sig-
nificant 0.44-mg/dl reduction in serum 
uric acid, which was associated with a 
significant mean decrease in the systolic 
blood pressure on the high- and low-
sodium diets. This result shows in the 
Mendelian randomization cohort that 
reduced uric acid lowered blood pres-
sure. See page 502.

http://www.kidney-international.org

	Chronic kidney disease following acute kidney injury 
	Hyperfiltration  and progression  in diabetes 
	Uric acid and  blood pressure