Characteristics and Outcomes of Survivors of Critical Illness and Acute Kidney Injury Followed in a Pilot Acute Kidney Injury Clinic

Ly, Han; Ortiz-Soriano, Victor; Liu, Lucas J.; Liu, Yu-Lun; Jin, Chen; Chang, Alex R.; Gutiérrez, Orlando M.; Siew, Edward D.; Wald, Ron; Silver, Samuel A.; Neyra, Javier A.

doi:10.1016/j.ekir.2021.08.017

Cited by 13 publications

(6 citation statements)

References 10 publications

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“…Supporting the effectiveness of structured kidney follow‐up, a study by Harel et al 41 demonstrated that mortality can be reduced if adult survivors of severe AKI are seen by a nephrologist within 90 days of discharge (8.4 versus 10.6 per 100 patient‐years). Translating these insights into a coordinated care model, Ly et al 42 reported their piloting experience with the implementation of AKI clinics and similarly found reductions in rehospitalizations, morbidity, and mortality. Certainly, these studies pave the way for a more integrated approach towards AKI.…”

Section: Discussionmentioning

confidence: 99%

Persistent Markers of Kidney Injury in Children Who Developed Acute Kidney Injury After Pediatric Cardiac Surgery: A Prospective Cohort Study

Eynde

Salaets

Louw

et al. 2022

JAHA

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Background Acute kidney injury (AKI) after pediatric cardiac surgery is common. Longer‐term outcomes and the incidence of chronic kidney disease after AKI are not well‐known. Methods and Results All eligible children (aged <16 years) who had developed AKI following cardiac surgery at our tertiary referral hospital were prospectively invited for a formal kidney assessment ≈5 years after AKI, including measurements of estimated glomerular filtration rate, proteinuria, α 1 ‐microglobulin, blood pressure, and kidney ultrasound. Longer‐term follow‐up data on kidney function were collected at the latest available visit. Among 571 patients who underwent surgery, AKI occurred in 113 (19.7%) over a 4‐year period. Fifteen of these (13.3%) died at a median of 31 days (interquartile range [IQR], 9–57) after surgery. A total of 66 patients participated in the kidney assessment at a median of 4.8 years (IQR, 3.9–5.7) after the index AKI episode. Thirty‐nine patients (59.1%) had at least 1 marker of kidney injury, including estimated glomerular filtration rate <90 mL/min per 1.73 m 2 in 9 (13.6%), proteinuria in 27 (40.9%), α 1 ‐microglobinuria in 5 (7.6%), hypertension in 13 (19.7%), and abnormalities on kidney ultrasound in 9 (13.6%). Stages 1 to 5 chronic kidney disease were present in 18 (27.3%) patients. Patients with CKD were more likely to have an associated syndrome (55.6% versus 20.8%, P =0.015). At 13.1 years (IQR, 11.2–14.0) follow‐up, estimated glomerular filtration rate <90 mL/min per 1.73 m² was present in 18 of 49 patients (36.7%), suggesting an average estimated glomerular filtration rate decline rate of −1.81 mL/min per 1.73 m² per year. Conclusions Children who developed AKI after pediatric cardiac surgery showed persistent markers of kidney injury. As chronic kidney disease is a risk factor for cardiovascular comorbidity, long‐term kidney follow‐up in this population is warranted.

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Section: Discussionmentioning

confidence: 99%

Persistent Markers of Kidney Injury in Children Who Developed Acute Kidney Injury After Pediatric Cardiac Surgery: A Prospective Cohort Study

Eynde

Salaets

Louw

et al. 2022

JAHA

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“…For other patients, they can be seen by their PCPs and referred to nephrology if they have residual CKD after the resolution of AKI and/or developed recurrent AKI. A recent study showed a lower all-cause mortality of 8.4% vs. 10.6% for AKI-D survivors who were seen by a nephrologist within 3 months of hospital discharge compared to AKI-D survivors who did not follow up with nephrology [ 36 ].…”

Section: Care For Aki Survivors: ( Table 1 )mentioning

confidence: 99%

Optimum Post-Discharge Care of Acute Kidney Injury (AKI) Survivors

Alwagdani

Awad

Abdel‐Rahman

2022

JCM

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Acute kidney injury (AKI) is a serious problem, affecting multiple organs, and is associated with a high mortality. The severe consequences of AKI extend beyond hospital discharge to the outpatient setting. While a plethora of literature exists guiding the management of AKI in the hospital setting, currently, there are no guidelines for the best care of AKI patients post-hospital discharge. In this review, we address the burden of AKI on patients and the importance of optimal coordinated care of these patients post-hospital discharge. We review the care of patients with or without dialysis requirements at the time of discharge and thereafter.

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“…39,40 Supporting the effectiveness of structured kidney follow-up, a study by Harel et al 41 demonstrated that mortality can be reduced if adult survivors of severe AKI are seen by a nephrologist within 90 days of discharge (8.4 versus 10.6 per 100 patient-years). Translating these insights into a coordinated care model, Ly et al 42 reported their piloting experience with the implementation of AKI clinics and similarly found reductions in rehospitalizations, morbidity, and mortality. Certainly, these studies pave the way for a more integrated approach towards AKI.…”

Section: Need For Structured Kidney Follow-up In Children With Chdmentioning

confidence: 99%

Children Who Developed Acute Kidney Injury After Pediatric Cardiac Surgery Have Persistent Markers of Renal Injury at Mid- And Long-Term Follow-Up

Eynde¹,

Salaets²,

Louw³

et al. 2022

Journal of the American College of Cardiology

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Characteristics and Outcomes of Survivors of Critical Illness and Acute Kidney Injury Followed in a Pilot Acute Kidney Injury Clinic

Cited by 13 publications

References 10 publications

Persistent Markers of Kidney Injury in Children Who Developed Acute Kidney Injury After Pediatric Cardiac Surgery: A Prospective Cohort Study

Persistent Markers of Kidney Injury in Children Who Developed Acute Kidney Injury After Pediatric Cardiac Surgery: A Prospective Cohort Study

Optimum Post-Discharge Care of Acute Kidney Injury (AKI) Survivors

Children Who Developed Acute Kidney Injury After Pediatric Cardiac Surgery Have Persistent Markers of Renal Injury at Mid- And Long-Term Follow-Up

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