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|Title:||Practice patterns and predictors of outpatient care following acute kidney injury in an Australian healthcare setting.||Austin Authors:||See, Emily J ;Ransley, David G;Polkinghorne, Kevan R;Toussaint, Nigel D;Bailey, Michael;Johnson, David W;Robbins, Raymond J ;Bellomo, Rinaldo||Affiliation:||Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia..
School of Medicine, University of Melbourne, Melbourne, Victoria, Australia..
Department of Nephrology, Monash Health, Melbourne, Victoria, Australia..
Department of Medicine, Monash University, Melbourne, Victoria, Australia..
Department for Continuing Education, University of Oxford, Oxford, UK..
Data Analytics Research and Evaluation (DARE) Centre
Translational Research Institute, Brisbane, Queensland, Australia..
Australasian Kidney Trials Network, Brisbane, Queensland, Australia..
Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia..
Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia..
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia..
Department of Nephrology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia..
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia..
Department of Epidemiology and Preventative Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia..
|Issue Date:||Jan-2022||Publication information:||Internal medicine journal 2022; 52(1): 79-88||Abstract:||Survivors of acute kidney injury (AKI) are at increased risk of major adverse kidney events and international guidelines recommend individuals be evaluated 3 months following AKI. We describe practice patterns and predictors of post-AKI care in an Australian tertiary hospital. A retrospective analysis was undertaken of adults with AKI (defined by KDIGO criteria) admitted to a single centre between 2012 and 2016. The primary outcome was outpatient nephrology review at 3 months. Secondary outcomes included inpatient nephrology review, and outpatient serum creatinine and urinary protein measurements. Data were analysed using multivariable logistic and competing risk regression. Only 117 of 2111 (6%) patients with AKI were reviewed by a nephrologist at 3 months. Reviewed patients were more likely to have a higher discharge serum creatinine (odds ratio (OR) 1.20 per 10 μmol/L increase; 95% confidence interval (CI) 1.16-1.25) or a history of peripheral vascular disease (OR 1.77; 95% CI 1.00-3.14). They were less likely to be older (OR 0.66 per decade; 95% CI 0.57-0.76) or to have a history of liver (OR 0.47; 95% CI 0.26-0.87) or ischaemic heart (OR 0.50; 95% CI 0.27-0.94) disease. AKI stage did not predict follow up. The median time from discharge to outpatient serum creatinine testing was 12 days (interquartile range 4-47) and proteinuria was measured in 538 (25%) patients. A minority of admitted AKI patients receive recommended post-AKI care. Studies in other Australian institutions are required to confirm or refute these concerning findings.||URI:||https://ahro.austin.org.au/austinjspui/handle/1/29099||DOI:||10.1111/imj.15138||ORCID:||https://orcid.org/0000-0003-4436-4319
|Journal:||Internal medicine journal||PubMed URL:||33197133||PubMed URL:||https://pubmed.ncbi.nlm.nih.gov/33197133/||Type:||Journal Article||Subjects:||acute kidney injury
major adverse kidney event
|Appears in Collections:||Journal articles|
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