Association of an Acute Kidney Injury Follow-up Clinic With Patient Outcomes and Care Processes: A Cohort Study
American Journal of Kidney Diseases, ISSN: 0272-6386, Vol: 81, Issue: 5, Page: 554-563.e1
2023
- 9Citations
- 19Captures
- 6Mentions
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Metrics Details
- Citations9
- Citation Indexes9
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- Captures19
- Readers19
- 19
- Mentions6
- News Mentions5
- News5
- Blog Mentions1
- Blog1
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Revised normative BP values for children show better discrimination of kidney disease risk
Researchers have found in new research that specialized post-discharge follow-up for AKI survivors was not associated with a lower risk of major adverse kidney events.
Article Description
To determine whether attendance at an acute kidney injury (AKI) follow-up clinic is associated with reduced major adverse kidney events. Propensity-matched cohort study. Patients hospitalized with AKI in Ontario, Canada, from February 1, 2013, through September 30, 2017, at a single clinical center, who were not receiving dialysis when discharged. Standardized assessment by a nephrologist. Time to a major adverse kidney event, defined as death, initiation of maintenance dialysis, or incident/progressive chronic kidney disease. Propensity scores were used to match each patient who attended an AKI follow-up clinic to 4 patients who received standard care. Cox proportional hazards models were fit to assess the association between the care within an AKI follow-up clinic and outcomes. To avoid immortal time bias, we randomly assigned index dates to the comparator group. We matched 164 patients from the AKI follow-up clinic to 656 patients who received standard care. During a mean follow-up of 2.2 ± 1.3 (SD) years, care in the AKI follow-up clinic was not associated with a reduction in major adverse kidney events relative to standard care (22.1 vs 24.7 events per 100 patient-years; HR, 0.91 [95% CI, 0.75-1.11]). The AKI follow-up clinic was associated with a lower risk of all-cause mortality (HR, 0.71 [95% CI, 0.55-0.91]). Patients aged at least 66 years who attended the AKI follow-up clinic were more likely to receive β-blockers (HR, 1.34 [95% CI, 1.02-1.77]) and statins (HR, 1.35 [95% CI, 1.05-1.74]), but not angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (HR, 1.21 [95% CI, 0.94-1.56]). Single-center study and residual confounding. Specialized postdischarge follow-up for AKI survivors was not associated with a lower risk of major adverse kidney events but was associated with a lower risk of death and increased prescriptions for some cardioprotective medications.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S0272638622010526; http://dx.doi.org/10.1053/j.ajkd.2022.10.011; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85146672229&origin=inward; http://www.ncbi.nlm.nih.gov/pubmed/36521779; https://linkinghub.elsevier.com/retrieve/pii/S0272638622010526; https://dx.doi.org/10.1053/j.ajkd.2022.10.011; https://www.ajkd.org/article/S0272-6386(22)01052-6/fulltext#.Y6NXmHxrjtM.twitter; http://www.ajkd.org/article/S0272638622010526/abstract; http://www.ajkd.org/article/S0272638622010526/fulltext; http://www.ajkd.org/article/S0272638622010526/pdf; https://www.ajkd.org/article/S0272-6386(22)01052-6/abstract; https://www.ajkd.org/article/S0272-6386(22)01052-6/fulltext; https://www.ajkd.org/article/S0272-6386(22)01052-6/fulltext?rss=yes&utm_source=dlvr.it&utm_medium=twitter
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