ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: FR-PO081

Multistate Modeling Patient Transitions from AKI to CKD or Death Using Electronic Health Records (EHR)

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Nestor, Jordan Gabriela, Columbia University, New York, New York, United States
  • Fang, Yilu, Columbia University, New York, New York, United States
  • Weng, Chunhua, Columbia University, New York, New York, United States
Background

Patients with AKI are at high risk for CKD and death. The epidemiology of these transitions is poorly understood. This study aims to characterize patient health trajectories from the initial AKI episode to CKD or all-cause mortality using EHR data from NewYork-Presbyterian/Columbia University.

Methods

This retrospective study included 20,699 patients. Clinical states were identified by clustering patient vectors derived from temporal medical codes and serum creatinine (SCr) time series using natural language processing models. Transition probabilities between clinical states and to outcomes (CKD or death) were estimated using multi-state modeling.

Results

In the AKI cohort, 17% developed CKD and 19% died. We identified 15 clinical states with varying disease burdens. Each state had unique transition probabilities over 5 years (Figure). Risk factors for each outcome were identified within different AKI subpopulations based on clinical state trajectories (Table).

Conclusion

This study enhances our understanding of patient trajectories from an initial AKI episode to CKD diagnosis or death by tracking the progression of medical conditions, interventions, treatments, and SCr levels over time.

Figure: Transition Probabilities Between Clinical States Over a 5-Year Period

Table: Risk Factors for CKD and All-Cause Mortality for Each Initial State Transition

Funding

  • Other NIH Support