对于急性肾损伤（AKI）和急性肾疾病（AKD）恢复肾功能的一致性定义尚不存在，不清楚不同人群和临床亚组之间的恢复情况有何差异。本研究采用了来自加拿大、丹麦和苏格兰的四个以人群为基础的队列的联合分析，时间跨度为2011-2018年。我们根据KDIGO AKI和AKD标准内的血清肌酐变化，在48小时、7天和90天内确定了新发生的AKD。另外，我们对365天内的变化进行了分析，以研究使用广泛的超过KDIGO AKI和AKD时间范围的电子报警实施情况。肾功能恢复是基于AKD的解决和随后的肌酐测量结果低于基线值的情况。我们评估了在一年内从非恢复到恢复和死亡之间的转变；在年龄、性别和合并疾病亚组之间的情况；在不同AKD定义下的亚组之间以及在不同队列之间的情况。共有464,868例新发病例，年龄中位数为67-75岁。在一年内，结果在不同队列之间保持一致，根据肌酐在48小时、7天、90天和365天内的变化，泊汇死亡率（和95%可信区间）分别为40%（34-45%）、40%（34-46%）、37%（31-42%）和22%（16-29%）；肾功能非恢复率分别为19%（15-23%）、30%（24-35%）、25%（21-29%）和37%（30-43%）。14天和90天的恢复往往在一年后无法持续。与年轻女性和糖尿病患者相比，年长男性和心力衰竭或癌症患者更容易死亡而不恢复，正好相反。对于多个队列之间的恢复情况，在一年的死亡率和非恢复率上，基于KDIGO AKD（90天内）至少与KDIGO AKI（7天内）具有相似的预后，且涵盖了更多人群。AKD相关的结局因年龄、性别和合并症而异，年长男性更容易死亡，而年轻女性更不容易恢复。© 作者（2023）。由牛津大学出版社代表ERA出版。

There are no consensus definitions for evaluating kidney function recovery after acute kidney injury (AKI) and acute kidney disease (AKD), nor is it clear how recovery varies across populations and clinical subsets. We present a federated analysis of four population-based cohorts from Canada, Denmark, and Scotland, 2011-2018.We identified incident AKD defined by serum creatinine changes within 48 hours, 7 days, and 90 days based on KDIGO AKI and AKD criteria. Separately, we applied changes up to 365 days to address widely used e-alert implementations that extend beyond the KDIGO AKI and AKD timeframes. Kidney recovery was based on resolution of AKD and a subsequent creatinine measurement below 1.2x baseline. We evaluated transitions between non-recovery, recovery, and death up to one year; within age, sex, and comorbidity subgroups; between subset AKD definitions; and across cohorts.There were 464 868 incident cases, median ages 67-75 years. At one year, results were consistent across cohorts, with pooled mortalities for creatinine changes within 48 hours, 7 days, 90 days and 365 days (and 95% CI) of 40% (34-45%), 40% (34-46%), 37% (31-42%), 22% (16-29%) respectively; and non-recovery of kidney function of 19% (15-23%), 30% (24-35%), 25% (21-29%), 37% (30-43%) respectively. Recovery by 14 and 90 days was frequently not sustained at one year. Older males and those with heart failure or cancer were more likely to die than experience sustained non-recovery, whereas the converse was true for younger females and those with diabetes.Consistently across multiple cohorts, based on one-year mortality and non-recovery, KDIGO AKD (up to 90 days) is at least prognostically similar to KDIGO AKI (7 days), and covers more people. Outcomes associated with AKD vary by age, sex and comorbidities such that older males are more likely to die, and younger females are less likely to recover.© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.