Outpatient Nephrology Referral Rates after Acute Kidney Injury

• DOI: 10.1681/asn.2011030315
• Publication Date: 2011-12-09T05:05:33Z
• Authors: Edward D. Siew; Josh F. Peterson; Svetlana K. Eden; Adriana M. Hung; Theodore Speroff; T. Alp Ikizler; Michael E. Matheny
• Keywords: Nephrology; Interquartile range; Veterans Affairs

AKI associates with an increased risk for the development and progression of CKD mortality. Processes care after episode are not well described. Here, we examined likelihood nephrology referral among survivors at subsequent decline in kidney function a US Department Veterans Affairs database. We identified 3929 hospitalized between January 2003 December 2008 who had estimated GFR (eGFR) <60 ml/min per 1.73 m(2) 30 days peak injury. analyzed time to considering improvement (eGFR ≥60 m(2)), dialysis initiation, death as competing risks over 12-month surveillance period. Median age was 73 years (interquartile range, 62-79 years) prevalence preadmission dysfunction (baseline eGFR m(2)) 60%. Overall mortality during period 22%. The cumulative incidence before dying, initiating dialysis, or experiencing 8.5% (95% confidence interval, 7.6-9.4). Severity did affect rates. These data demonstrate that minority at-risk referred AKI. Determining how best identify highest complications could facilitate early nephrology-based interventions.