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Strategies to Enhance Rehabilitation After Acute Kidney Injury in the Developing World

Acute kidney injury (AKI) is independently associated with new-onset chronic kidney disease (CKD), end-stage kidney disease, cardiovascular disease, and all-cause mortality. However, only a minority of patients receive follow-up care after an episode of AKI in the developing world, and the optimal s...

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Autores principales: Silver, Samuel A., Adu, Dwomoa, Agarwal, Sanjay, Gupta, K.L., Lewington, Andrew J.P., Pannu, Neesh, Bagga, Arvind, Chakravarthi, Rajasekara, Mehta, Ravindra L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678669/
http://dx.doi.org/10.1016/j.ekir.2017.04.005
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author Silver, Samuel A.
Adu, Dwomoa
Agarwal, Sanjay
Gupta, K.L.
Lewington, Andrew J.P.
Pannu, Neesh
Bagga, Arvind
Chakravarthi, Rajasekara
Mehta, Ravindra L.
author_facet Silver, Samuel A.
Adu, Dwomoa
Agarwal, Sanjay
Gupta, K.L.
Lewington, Andrew J.P.
Pannu, Neesh
Bagga, Arvind
Chakravarthi, Rajasekara
Mehta, Ravindra L.
author_sort Silver, Samuel A.
collection PubMed
description Acute kidney injury (AKI) is independently associated with new-onset chronic kidney disease (CKD), end-stage kidney disease, cardiovascular disease, and all-cause mortality. However, only a minority of patients receive follow-up care after an episode of AKI in the developing world, and the optimal strategies to promote rehabilitation after AKI are ill-defined. On this background, a working group of the 18th Acute Dialysis Quality Initiative applied the consensus-building process informed by a PubMed review of English-language articles to address questions related to rehabilitation after AKI. The consensus statements propose that all patients should be offered follow-up within 3 months of an AKI episode, with more intense follow-up (e.g., <1 month) considered based on patient risk factors, characteristics of the AKI event, and the degree of kidney recovery. Patients should be monitored for renal and nonrenal events post-AKI, and we suggest that the minimum level of monitoring consist of an assessment of kidney function and proteinuria within 3 months of the AKI episode. Care should be individualized for higher risk patients, particularly patients who are still dialysis dependent, to promote renal recovery. Although evidence-based treatments for survivors of AKI are lacking and some outcomes may not be modifiable, we recommend simple interventions such as lifestyle changes, medication reconciliation, blood pressure control, and education, including the documentation of AKI in the patient’s medical record. In conclusion, survivors of AKI represent a high-risk population, and these consensus statements should provide clinicians with guidance on the care of patients after an episode of AKI.
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spelling pubmed-56786692017-11-15 Strategies to Enhance Rehabilitation After Acute Kidney Injury in the Developing World Silver, Samuel A. Adu, Dwomoa Agarwal, Sanjay Gupta, K.L. Lewington, Andrew J.P. Pannu, Neesh Bagga, Arvind Chakravarthi, Rajasekara Mehta, Ravindra L. Kidney Int Rep Meeting Report Acute kidney injury (AKI) is independently associated with new-onset chronic kidney disease (CKD), end-stage kidney disease, cardiovascular disease, and all-cause mortality. However, only a minority of patients receive follow-up care after an episode of AKI in the developing world, and the optimal strategies to promote rehabilitation after AKI are ill-defined. On this background, a working group of the 18th Acute Dialysis Quality Initiative applied the consensus-building process informed by a PubMed review of English-language articles to address questions related to rehabilitation after AKI. The consensus statements propose that all patients should be offered follow-up within 3 months of an AKI episode, with more intense follow-up (e.g., <1 month) considered based on patient risk factors, characteristics of the AKI event, and the degree of kidney recovery. Patients should be monitored for renal and nonrenal events post-AKI, and we suggest that the minimum level of monitoring consist of an assessment of kidney function and proteinuria within 3 months of the AKI episode. Care should be individualized for higher risk patients, particularly patients who are still dialysis dependent, to promote renal recovery. Although evidence-based treatments for survivors of AKI are lacking and some outcomes may not be modifiable, we recommend simple interventions such as lifestyle changes, medication reconciliation, blood pressure control, and education, including the documentation of AKI in the patient’s medical record. In conclusion, survivors of AKI represent a high-risk population, and these consensus statements should provide clinicians with guidance on the care of patients after an episode of AKI. Elsevier 2017-04-26 /pmc/articles/PMC5678669/ http://dx.doi.org/10.1016/j.ekir.2017.04.005 Text en © 2017 International Society of Nephrology. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Meeting Report
Silver, Samuel A.
Adu, Dwomoa
Agarwal, Sanjay
Gupta, K.L.
Lewington, Andrew J.P.
Pannu, Neesh
Bagga, Arvind
Chakravarthi, Rajasekara
Mehta, Ravindra L.
Strategies to Enhance Rehabilitation After Acute Kidney Injury in the Developing World
title Strategies to Enhance Rehabilitation After Acute Kidney Injury in the Developing World
title_full Strategies to Enhance Rehabilitation After Acute Kidney Injury in the Developing World
title_fullStr Strategies to Enhance Rehabilitation After Acute Kidney Injury in the Developing World
title_full_unstemmed Strategies to Enhance Rehabilitation After Acute Kidney Injury in the Developing World
title_short Strategies to Enhance Rehabilitation After Acute Kidney Injury in the Developing World
title_sort strategies to enhance rehabilitation after acute kidney injury in the developing world
topic Meeting Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678669/
http://dx.doi.org/10.1016/j.ekir.2017.04.005
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