Improving Care for Patients After Hospitalization with AKI
Acute kidney injury (AKI) is an increasingly common condition affecting hospitalized patients that is associated with future chronic kidney disease (CKD), cardiovascular events, diminished health-care quality of life, and death. Multiple studies highlight rapid growth in the incidence of AKI, and with it, parallel increases in the population of survivors.
Retrospective and prospective studies show a proportion of patients without preexisting CKD experience significant loss of renal function over the long-term after an episode of AKI, resulting in the development of new incident CKD. Approximately 20% of such patients with AKI, usually of the greatest severity, will develop CKD over a 3 to 5-year follow-up. Risk factors for the development of CKD after AKI, such as age, race and disease severity have been identified. Although several therapeutic interventions for AKI during hospitalization have been tested, none is effective in changing the course of the disease.
A large proportion of patients with AKI during hospitalization do not receive appropriate outpatient follow-up. The transition of care and beyond as a window to improve clinical and patient-centered outcomes in this population has been identified. How patients should be treated – including processes of care, level of hypertension control, and the use of blockers of the renin-angiotensin system -- in the post-AKI outpatient setting is unknown. Current clinical practice guidelines lack high-quality evidence to inform care recommendations.
- To facilitate the development of strategies in this multidisciplinary workshop to improve clinical outcomes among patients surviving an episode of Acute Kidney Injury (AKI).
- To bring together experts to review the current literature describing potential interventions following AKI, review preclinical data that might inform mechanisms that drive susceptibility to future chronic kidney disease (CKD) and cardiovascular events, and identify knowledge gaps that need to be addressed in order to better inform clinical care.
- To identify possible interventions, and parameters of key interest for evaluation, feasibility of studies, and provide preliminary power analyses for the performance of future studies.
January 18, 2019