title: Delayed Nephrology Consultation and High Mortality on Acute Kidney Injury: A Meta-Analysis.
abstract: BACKGROUND
  Acute kidney injury (AKI) is a complex syndrome associated with substantial morbidity, mortality and costs. Despite advancements in diagnosis and care practice, AKI remains a disorder usually under/late-recognized with high mortality. One of the hidden reasons for poor outcome might be delayed nephrology consultation, with the involvement of the specialist only in severe stages of AKI when renal replacement therapy (RRT) is required.
  
  
  METHODS
  We searched PubMed, EMBASE and Cochrane central register for related work on the subject. Six studies were identified for the meta-analysis, correlating time of nephrology consultation and mortality in AKI.
  
  
  RESULTS
  We found that delayed nephrology consultation is associated with higher mortality in AKI, with an OR 0.79 (95% CI 0.48-1.10, p < 0.05).
  
  
  CONCLUSIONS
  Delayed nephrology consultation contributes to higher mortality in AKI. The early involvement of nephrologist may present an advantage in terms of early recognition, prevention and effective treatment of AKI. An early involvement of multidisciplinary task force may contribute to better treatment, before the preventable complications of AKI occur or an emergency RRT is required.
authors.affiliation: Unidade de Tratamento Nefrológico (UTN), Rio de Janeiro, Brazil.
authors.forename: Débora M
authors.initials: DM
authors.lastname: Soares
authors.forename: José F
authors.initials: JF
authors.lastname: Pessanha
authors.forename: Aashish
authors.initials: A
authors.lastname: Sharma
authors.forename: Alessandra
authors.initials: A
authors.lastname: Brocca
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D057210:Delayed Diagnosis / Q000401:mortality*; D006801:Humans; D007400:Interprofessional Relations; D000072104:Nephrologists; D012017:Referral and Consultation