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Adv Chronic Kidney Dis. 2017 Jul;24(4):246-252. doi: 10.1053/j.ackd.2017.05.008.

Follow-up Care in Acute Kidney Injury: Lost in Transition.

Author information

1
Division of Nephrology, University of Toronto, Toronto, Canada; Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA; Tennessee Valley Healthcare System (TVHS), Veterans Administration (VA) Medical Center, Veteran's Health Administration, Nashville, TN; Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN; and Vanderbilt Center for Kidney Disease (VCKD) and Integrated Program for AKI Research (VIP-AKI), Nashville, TN. Electronic address: sam.silver@utoronto.ca.
2
Division of Nephrology, University of Toronto, Toronto, Canada; Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA; Tennessee Valley Healthcare System (TVHS), Veterans Administration (VA) Medical Center, Veteran's Health Administration, Nashville, TN; Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN; and Vanderbilt Center for Kidney Disease (VCKD) and Integrated Program for AKI Research (VIP-AKI), Nashville, TN.

Abstract

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.

KEYWORDS:

Acute kidney injury; Care transitions; Long-term outcomes; Quality improvement

PMID:
28778365
DOI:
10.1053/j.ackd.2017.05.008
[Indexed for MEDLINE]

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