Critically ill patients requiring acute renal replacement therapy are at an increased risk of long-term renal dysfunction, but rarely receive specialist nephrology follow-up

Nephron
Christopher J KirwanJohn R Prowle

Abstract

Episodes of acute kidney injury (AKI) have been associated with the development of chronic kidney disease (CKD). However, follow-up pathways for patients who have survived AKI complicating critical illness are not well established. We hypothesised that patients who had AKI requiring renal replacement therapy (RRT) in intensive care are at risk of CKD, but are rarely referred for nephrology follow-up at hospital discharge. We performed a retrospective analysis of all patients who survived AKI requiring renal replacement therapy in intensive care units (ICUs) in the East London region, examining renal function at baseline, hospital discharge and 3-6 months follow-up. We excluded patients who were known to renal services prior to index admission. From 5,544 critical care admissions, we identified 219 patients who survived to be discharged, having undergone RRT for AKI, that were not previously known to renal services. Of these, 124 (57%) had creatinine measured within 3-6 months after discharge, 104 having a pre-morbid baseline for comparison. Only 26 patients (12%) received specialist nephrology follow-up. At 3-6 months follow-up, the estimated glomerular filtration rate was significantly lower than baseline (48 vs. 60 ml/min/1.7...Continue Reading

Citations

Nov 6, 2015·Current Opinion in Critical Care·Samuel A Silver, Ron Wald
Sep 28, 2015·Critical Care Clinics·James F Doyle, Lui G Forni
Feb 28, 2017·Nature Reviews. Nephrology·Lakhmir S ChawlaUNKNOWN Acute Disease Quality Initiative Workgroup 16.
Feb 1, 2017·Intensive Care Medicine·Peter PickkersMiet Schetz
Dec 26, 2017·Hospital Pharmacy·Sandra L Kane-Gill, Seth R Bauer
Mar 27, 2018·Nephrology·Silvia CoelhoAntónio Jacinto
May 4, 2017·Intensive Care Medicine·L G ForniM Joannidis
Sep 7, 2017·Medizinische Klinik, Intensivmedizin und Notfallmedizin·S J KleinM Joannidis
May 24, 2017·Intensive Care Medicine·Miet Schetz, Matthieu Legrand
Jan 10, 2018·British Journal of Hospital Medicine·Tessa E Dessain, Daniel Martin
Feb 23, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Rebecca A NobleNicholas M Selby
Apr 20, 2019·Clinical Journal of the American Society of Nephrology : CJASN·Scott L WeissBenjamin L Laskin
Apr 10, 2019·Deutsches Ärzteblatt International·Mark Dominik AlscherMartin K Kuhlmann
Mar 30, 2021·Clinical Kidney Journal·Joana GameiroJosé António Lopes
Sep 2, 2021·Critical Care : the Official Journal of the Critical Care Forum·Peerapat ThanapongsatornNattachai Srisawat

❮ Previous
Next ❯

Related Concepts

Related Feeds