title: Improving outcomes of acute kidney injury survivors.
abstract: OBJECTIVE
  Acute kidney injury (AKI) is a common problem in critically ill patients, with long-term health implications that extend beyond hospital discharge. Though they are at a high risk of adverse events, AKI survivors may not be receiving adequate postdischarge medical attention. This review discusses recently published data regarding health outcomes after AKI, the current state of post-AKI care, and potential opportunities to improve outpatient care after AKI.
  
  
  RESULTS
  In addition to predisposing to de-novo chronic kidney disease or an exacerbation of previously existing chronic kidney disease, a prior episode of AKI has been linked to subsequent cardiac events, cerebrovascular events, and the need for hospital readmission. Despite this, a population-wide study in Ontario showed that only 40% of patients surviving an episode of dialysis-requiring AKI visited a nephrologist within 90 days of hospital discharge. This care gap is important since outpatient contact with a nephrologist during this critical period was associated with enhanced survival.
  
  
  CONCLUSIONS
  AKI is associated with a number of long-term health effects, and new strategies may be needed to address this emerging public health issue. An ambulatory program dedicated to the postdischarge care of AKI survivors may confer a variety of benefits. Future research is needed to evaluate this model of care.
authors.affiliation: aDivision of Nephrology, St. Michael's Hospital, University of Toronto bLi Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Silver
authors.forename: Ron
authors.initials: R
authors.lastname: Wald
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003404:Creatinine / Q000097:blood; D016638:Critical Illness / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D011787:Quality of Health Care / Q000458:organization & administration; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D003404:Creatinine