Planning Patient Care after Acute Kidney Injury: Not as Easy as It May Seem
| Autor: | Nicholas M. Selby, Rebecca Noble |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Epidemiology Aftercare Pilot Projects urologic and male genital diseases Critical Care and Intensive Care Medicine Patient care Nephrologists Renal Dialysis Humans Medicine Renal Insufficiency Chronic Stage (cooking) Intensive care medicine Aged Transplantation urogenital system business.industry Mortality rate Acute kidney injury Acute Kidney Injury Middle Aged Patient Acceptance of Health Care medicine.disease female genital diseases and pregnancy complications Hospitalization Editorial Nephrology Disease Progression Feasibility Studies Female business Complication |
| Zdroj: | Clin J Am Soc Nephrol |
| ISSN: | 1555-905X 1555-9041 |
| DOI: | 10.2215/cjn.06380521 |
| Popis: | Survivors of AKI are at higher risk of CKD and death, but few patients see a nephrologist after hospital discharge. Our objectives during this 2-year vanguard phase trial were to determine the feasibility of randomizing survivors of AKI to early follow-up with a nephrologist or usual care, and to collect data on care processes and outcomes.We performed a randomized controlled trial in patients hospitalized with Kidney Disease Improving Global Outcomes (KDIGO) stage 2-3 AKI at four hospitals in Toronto, Canada. We randomized patients to early nephrologist follow-up (standardized basket of care that emphasized BP control, cardiovascular risk reduction, and medication safety) or usual care from July 2015 to June 2017. Feasibility outcomes included the proportion of eligible patients enrolled, seen by a nephrologist, and followed to 1 year. The primary clinical outcome was a major adverse kidney event at 1 year, defined as death, maintenance dialysis, or incident/progressive CKD.We screened 3687 participants from July 2015 to June 2017, of whom 269 were eligible. We randomized 71 (26%) patients (34 to nephrology follow-up and 37 to usual care). The primary reason stated for declining enrollment included hospitalization-related fatigue (Major adverse kidney events are common in AKI survivors, but we found the in-person model of follow-up posed a variety of barriers that was not acceptable to many patients.Nephrologist Follow-up versus Usual Care after an Acute Kidney Injury Hospitalization (FUSION), NCT02483039 CJASN 16: 1005-1014, 2021. doi: https://doi.org/10.2215/CJN.17331120. |
| Databáze: | OpenAIRE |
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