The Role of Adaptive and Maladaptive Repair Biomarkers in Predicting Cardiac and Renal Outcomes after an Episode of AKI (Ancillary Study using ASSESS-AKI)

Acute kidney injury (AKI) is a risk factor for chronic kidney disease (CKD) and cardiovascular disease (CVD) with several biological processes orchestrating either recovery or progression to poor long-term outcomes after the initial insult of AKI. Some biological processes after injury lead to adaptive repair and regeneration of tubules and vessels, while others lead to maladaptive repair and fibrosis. The ASsessment, Serial Evaluation, and Subsequent Sequelae in Acute Kidney Injury (ASSESS-AKI) network is a prospective, observational cohort of hospitalized patients with and without AKI, with 4 years of follow-up.

We propose an ancillary study using samples and participants from the ASSESS-AKI cohort to evaluate the association of adaptive and maladaptive repair biomarkers with CVD and kidney disease progression. CVD is defined as coronary heart disease, heart failure, cardiac arrhythmias or stroke. Kidney disease progression is defined as incident CKD, progression of pre-existing CKD, or development of end-stage renal disease.

We will assess the following maladaptive repair biomarkers:

• ang-2, MMP-2, PIIINP, TGFβ, VEGFR-1 and MCP-1

and the following adaptive biomarkers:

• VEGF, ang-1, sTie-2, and PGF at index hospitalization, 3 months and 12 months after index hospitalization
  

and the following adaptive biomarkers: