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Acute Kidney Injury (AKI) during critical illness increases the risk of subsequent chronic kidney disease. Guidelines recommend inpatient nephrology assessment and review at 3 months. To quantify the prevalence and predictors of inpatient and outpatient nephrology METHODS: Retrospective study of all critically ill adults with AKI between 1 January 2012 and 31 December 2016 with a baseline eGFR >30 mL/min/1.73m2 and alive and independent of renal replacement therapy for 30 days after hospital discharge. We used logistic regression models to examine the primary outcome of nephrology review at 3 months. Secondary outcomes included inpatient nephrology review, renal recovery at discharge, and the development of a major adverse kidney event (MAKE) at one year. Of 702 critically ill patients with AKI (mean age 66 years, 64% male, baseline eGFR 78 mL/min/1.73m2), 43 patients (6%) received nephrology follow up at 3 months and 63 patients (9%) at one year. Nephrology follow up occurred more frequently in patients with a higher baseline creatinine, a higher discharge creatinine, and greater severity of AKI. Seventy patients (10%) underwent inpatient nephrology review. Overall, 414 (59%) had recovery of renal function by the time of discharge and 239 (34%) developed a MAKE at 12 months. Inpatient and outpatient nephrology follow-up of AKI patients after admission to a critical care area was uncommon although one third developed a MAKE. These findings provide the rationale for controlled studies of nephrology follow-up. This article is protected by copyright. All rights reserved. |
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