{"title":"Outcomes after acute kidney injury and critical illness.","authors":"Rachel Jeong, Ryan Haines, Marlies Ostermann","doi":"10.1097/MCC.0000000000001183","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Acute kidney injury (AKI) in critical illness is common, and survivors are faced with a host of adverse outcomes. In this article, we review the current landscape of outcomes and care in survivors of AKI and critical illness.</p><p><strong>Recent findings: </strong>Follow-up care of survivors of AKI and critical illness is prudent to monitor for and mitigate the risk of adverse outcomes. Observational data have suggested improvement in outcomes with nephrology-based follow-up care, and recent interventional studies demonstrate similar findings. However, current post-AKI care is suboptimal with various challenges, such as breakdowns in the transition of care during hospital episodes and into the community, barriers for patients in follow-up, and lack of identification of high-risk patients for nephrology-based follow-up. Tools predictive of renal nonrecovery and long-term outcomes may help to identify high-risk patients who may benefit the most from nephrology-based care post-AKI.</p><p><strong>Summary: </strong>Follow-up care of survivors of AKI and critical illness may improve outcomes and there is a need to prioritize transitions of care into the community. Further research is needed to elucidate the best ways to risk-stratify and manage post-AKI survivors to improve outcomes.</p>","PeriodicalId":10851,"journal":{"name":"Current Opinion in Critical Care","volume":null,"pages":null},"PeriodicalIF":3.5000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Critical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MCC.0000000000001183","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/19 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose of review: Acute kidney injury (AKI) in critical illness is common, and survivors are faced with a host of adverse outcomes. In this article, we review the current landscape of outcomes and care in survivors of AKI and critical illness.
Recent findings: Follow-up care of survivors of AKI and critical illness is prudent to monitor for and mitigate the risk of adverse outcomes. Observational data have suggested improvement in outcomes with nephrology-based follow-up care, and recent interventional studies demonstrate similar findings. However, current post-AKI care is suboptimal with various challenges, such as breakdowns in the transition of care during hospital episodes and into the community, barriers for patients in follow-up, and lack of identification of high-risk patients for nephrology-based follow-up. Tools predictive of renal nonrecovery and long-term outcomes may help to identify high-risk patients who may benefit the most from nephrology-based care post-AKI.
Summary: Follow-up care of survivors of AKI and critical illness may improve outcomes and there is a need to prioritize transitions of care into the community. Further research is needed to elucidate the best ways to risk-stratify and manage post-AKI survivors to improve outcomes.
综述的目的:危重症急性肾损伤(AKI)很常见,幸存者面临着一系列不良后果。在这篇文章中,我们回顾了 AKI 和危重症幸存者目前的预后和护理情况:对 AKI 和危重症幸存者的随访护理对于监测和降低不良后果的风险非常重要。观察性数据表明,肾脏内科随访护理可改善预后,最近的介入性研究也有类似发现。然而,目前的急性肾损伤后护理并不理想,面临着各种挑战,如住院期间和进入社区后的护理过渡中断、患者在随访中遇到障碍以及缺乏对高危患者进行肾脏内科随访的识别。预测肾功能未恢复和长期预后的工具可能有助于识别高风险患者,这些患者可能从肾脏病肾病术后的护理中获益最多:AKI 和危重病幸存者的随访护理可改善预后,有必要优先考虑向社区的护理过渡。需要进一步研究阐明对 AKI 后幸存者进行风险分级和管理以改善预后的最佳方法。
期刊介绍:
Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.