Study finds 30% of patients with AKI do not receive adequate follow-up
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Research presented at the virtual ASN Kidney Week suggested 30% of patients hospitalized with AKI received inadequate follow-up, with medical risk factors being the “primary determinants” of care after hospitalization.
“[AKI] affects 20% of hospitalized patients and results in long-term adverse outcomes,” Erin F. Barreto, PharmD, RPh, of the Mayo Clinic in Rochester, and colleagues wrote in a poster. “To limit its complications, post-discharge follow-up is advised. The objective of the study was to evaluate the frequency of appropriate follow-up after discharge among AKI survivors.”
For the study, researchers included 563 patients who had an episode of AKI during hospitalization at the Mayo Clinic (64% had stage 2 AKI; 36% had stage 3) and examined the adequacy of follow-up care. Adequate care was defined by the patient having a serum creatinine level assessment and/or an in-person health care visit within 30 days, 90 days or 1 year after discharge.
They found the 30-day cumulative incidence of follow-up with serum creatinine assessment was 78% and was 80% by provider visit. Follow-up with both serum creatine assessment and a health care provider visit was 70%.
The incidences of both serum creatinine assessment and provider visit increased to 81% within 90 days after discharge and 91% within 1 year after discharge.
“Within 30-days after discharge, only 13% of these stage 2 or 3 AKI survivors saw a nephrologist,” Barreto and colleagues wrote.
Regarding the likelihood of follow-up within 30 days, researchers observed medical risk factors — including higher BMI, lower kidney function at baseline and discharge, higher comorbidity burden, greater AKI severity and longer duration of AKI during hospitalization — more accurately predicted adequate follow-up than did social or demographic characteristics.
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Barreto EF, et al. PO0007. Presented at: ASN Kidney Week. Oct. 22-25, 2020 (virtual meeting).
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