# National Study of Community-Acquired Acute Kidney Injury Epidemiology and Outcomes

> **NIH NIH R01** · DUKE UNIVERSITY · 2021 · $270,472

## Abstract

PROJECT SUMMARY
Community-acquired acute kidney injury (CA-AKI) is the development of AKI outside of the hospital setting and
is the most common form of AKI. Much of the research to date on CA-AKI has been limited to episodes during
an acute hospitalization (i.e. patients found to have AKI upon admission), which represents only a fraction of
the overall CA-AKI burden. Notably, these CA-AKI estimates are largely assessed in studies conducted in
integrated health systems outside of the United States (US); such national estimates are lacking in US
populations. Despite this scant evidence base, estimates indicate that a majority of CA-AKI events do not
result in acute hospitalization, yet outpatient CA-AKI events remain poorly characterized. Regardless of setting,
CA-AKI portends a significantly high risk of poor long-term outcomes, including increased risk of
hospitalization, poor renal outcomes and death. Moreover, there is a limited evidence that informs the few
guidelines directing CA-AKI management, and none delineate the role of the provider in CA-AKI aftercare or
outcomes. Through a systematic program of research, the goal of this study is to assess the continuum of CA-
AKI through rigorous evaluation of 1) measurement approaches for identifying CA-AKI, 2) CA-AKI clinical
outcomes, and 3) risk factors and etiologies for CA-AKI development. This will be accomplished by merging
several years of national Veterans Healthcare Administration's laboratory and administrative data with
Medicare administrative data to facilitate a national evaluation of CA-AKI development and subsequent clinical
consequences. This project has three specific aims: Aim 1 of this study will describe the epidemiology of CA-
AKI, by applying various clinical measurement approaches to define CA-AKI development and describe CA-
AKI incidence in the Veterans Health administration, and Aim 2 will assess the risk of adverse clinical
outcomes including hospitalization or death associated with CA-AKI development. Building from this work, Aim
3 will classify the most common clinical types of CA-AKI among veterans with identified CA-AKI. Our approach
is innovative because it will be the first study to: (1) use national datasets to comprehensively examine
outpatient-based CA-AKI outcomes in a US population cohort and (2) identify the most common types of CA-
AKI which will inform tailored CA-AKI risk stratification. This project will identify areas for improving care
standards for prevention and clinical management of CA-AKI, provide a critically needed empirical basis to
refine clinical guidelines, and inform the development of future, targeted interventions designed to improve the
clinical management of CA-AKI and related morbidity and mortality.

## Key facts

- **NIH application ID:** 10168529
- **Project number:** 5R01DK120732-03
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Clarissa Jonas Diamantidis
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $270,472
- **Award type:** 5
- **Project period:** 2019-09-20 → 2023-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10168529

## Citation

> US National Institutes of Health, RePORTER application 10168529, National Study of Community-Acquired Acute Kidney Injury Epidemiology and Outcomes (5R01DK120732-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10168529. Licensed CC0.

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