Improving Care after Acute Kidney Injury: A Prospective Time Series Study

Nephron
Samuel A SilverRon Wald

Abstract

Acute kidney injury (AKI) complicates 15-20% of hospitalizations, and AKI survivors are at increased risk of chronic kidney disease and death. However, less than 20% of patients see a nephrologist within 3 months of discharge, even though a nephrologist visit within 90 days of discharge is associated with enhanced survival. To address this, we established an AKI Follow-Up Clinic and characterized the patterns of care delivered. We conducted a prospective time series study. All hospitalized patients who developed Kidney Disease Improving Global Outcomes (KDIGO) stage 2 or 3 AKI were eligible. The pre-intervention period consisted of electronic reminders to the nephrology consults and cardiovascular surgery services to refer to the AKI Follow-Up Clinic. In the post-intervention period, eligible patients were automatically scheduled into the AKI Follow-Up Clinic at discharge. The primary outcome was the percentage of KDIGO stages 2-3 AKI survivors assessed by a nephrologist within 30 days of discharge. In the pre-intervention period, 8 of 46 patients (17%) were seen by a nephrologist within 30 days after discharge, and no additional patients were seen for 90 days. In the post-intervention period, 17 of 69 patients (25%) were seen ...Continue Reading

Citations

Nov 6, 2015·Current Opinion in Critical Care·Samuel A Silver, Ron Wald
Mar 1, 2016·Canadian Journal of Kidney Health and Disease·Ravindra MehtaUNKNOWN Acute Dialysis Quality Initiative (ADQI) Consensus Group
Mar 27, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Samuel A SilverGlenn M Chertow
Feb 28, 2017·Nature Reviews. Nephrology·Lakhmir S ChawlaUNKNOWN Acute Disease Quality Initiative Workgroup 16.
Feb 14, 2020·Nature Reviews. Nephrology·Matthew T JamesMarcello Tonelli
Oct 27, 2018·Critical Care Research and Practice·Claire Rimes-StigareMax Bell
Nov 14, 2017·Nephron·Jill VanmassenhoveNorbert Lameire
May 4, 2017·Intensive Care Medicine·L G ForniM Joannidis
Dec 18, 2019·Clinical Journal of the American Society of Nephrology : CJASN·Chi-Yuan HsuAlan S Go
Jul 12, 2020·Journal of Nephrology·J T KurzhagenH Rabb
Dec 16, 2017·Journal of the American Society of Nephrology : JASN·Samuel A SilverRon Wald
Oct 8, 2020·Current Opinion in Critical Care·Jay L KoynerJosee Bouchard
Apr 22, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Jessica A VanderlindenJ Gordon Boyd
May 23, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Samuel A SilverRon Wald

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