Journal
ADVANCES IN CHRONIC KIDNEY DISEASE
Volume 24, Issue 4, Pages 246-252Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.ackd.2017.05.008
Keywords
Acute kidney injury; Care transitions; Long-term outcomes; Quality improvement
Categories
Funding
- Kidney Research Scientist Core Education and National Training Program Post-Doctoral Fellowship
- Kidney Foundation of Canada
- Canadian Society of Nephrology
- Canadian Institutes of Health Research
- Veterans Administration HSRD Merit Award [IIR 13-073]
- National Institutes of Health from National Institute of Diabetes and Digestive and Kidney Diseases [5U01DK082192-10]
- Vanderbilt Center for Kidney Disease
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Acute kidney injury (AKI) is an increasingly common condition that is associated with long-term health outcomes. Recent studies have demonstrated that AKI, particularly when severe or persistent, is associated with all-cause mortality, CKD, ESRD, cardiovascular events, and reduced quality of life. However, data from multiple health care systems indicate that most patients do not see a nephrologist, although 1 study has suggested patients with AKI requiring dialysis may benefit from doing so. These observations raise the greater questions of what are the elements of care that may improve outcomes in survivors of AKI and which survivors need to be seen. Potential opportunities to improve care include appropriate risk stratification, closer monitoring of kidney function, management of CKD complications, blood pressure control, medication reconciliation, and education. Nephrologists are in an ideal position to lead and advocate for outpatient care pathways for survivors of AKI. In this article, we review the evidence supporting patient follow-up after AKI, describe the current state of follow-up care, and examine strategies to improve long-term outcomes for this high-risk population. (C) 2017 by the National Kidney Foundation, Inc. All rights reserved.
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