Acute Kidney Injury Care Following Hospitalization: Care Provision and Public Policy for Acute Kidney Injury Survivors

Abstract

The global incidence of acute kidney injury (AKI) is increasing. AKI is associated with both short- and long-term risks, including increased risk of chronic kidney disease and kidney failure, cardiovascular events, and all-cause death. This review summarizes existing posthospitalization AKI care guidelines, interprets the current state of evidence for AKI survivor care models including nephrology-specific and multidisciplinary team interventions, and details the health policy landscape for AKI survivors receiving outpatient dialysis in the United States. The main finding of this review is that evidence supporting specific posthospitalization AKI care interventions is very limited, resulting in imprecise consensus-based practice recommendations by national and international kidney societies for AKI survivors. The main implication of this work is to highlight the urgent need for additional research evaluating the efficacy of different care models among AKI survivors at high risk of maintenance dialysis, progression of kidney disease, rehospitalization, and death to devise value-based care models and clinical interventions that improve patient outcomes.