Care of the Acute Kidney Injury Survivor

Wald, Ron; Kitchlu, Abhijat; Harel, Ziv; Silver, Samuel A.

doi:10.1159/000484113

Cited by 6 publications

(6 citation statements)

References 21 publications

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“…However, the value of the AKI Clinic model needs to be further studied with properly designed interventional studies that focus not only on hard outcomes such as mortality, CKD, or ESRD but also on patient-centered outcomes including quality of life, cardiovascular comorbidity and cognitive function. 18 We believe that the barriers for optimal follow-up of AKI survivors include incomplete awareness of the multiple AKI consequences by the health care team and ineffective education maneuvers for patients and/or caregivers during the hospitalization.…”

Section: Discussionmentioning

confidence: 99%

“…Acute kidney injury survivors were defined as patients who have achieved clinical stability and were discharged from the hospital, irrespective of their degree of kidney recovery. 18 The post-discharge AKI Clinic was established at the University of Kentucky Medical Center in October of 2016 following the model described by Silver and colleagues. 22 The main goal of the AKI Clinic was to evaluate kidney recovery in AKI survivors during the first 90 days post-discharge as this may be informative for their subsequent risk of recurrent AKI or incident/progressive CKD or end-stage renal disease (ESRD).…”

Section: Methodsmentioning

confidence: 99%

“…Although AKI survivors are at high risk of several multiorgan complications, only a minority of them are evaluated by a nephrologist within the first 3 months of hospital discharge. 17-19 Furthermore, there are only few specialized AKI Clinics dedicated to following AKI survivors post-discharge. 20-22 In this context, there is paucity of research dedicated to examine and/or promote AKI literacy in AKI survivors.…”

Section: Introductionmentioning

confidence: 99%

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A Survey Study of Self-Rated Patients’ Knowledge About AKI in a Post-Discharge AKI Clinic

Ortiz-Soriano

Alcorn

et al. 2019

Can J Kidney Health Dis

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Background: Survivors of acute kidney injury (AKI) are at risk of adverse outcomes. Post-discharge nephrology care may improve patients’ AKI knowledge and prevent post-AKI complications. Objective: The purpose of this study was to examine patients’ awareness about their AKI diagnosis and self-rated knowledge and severity of AKI before and after their first post-discharge AKI Clinic encounter. Design: We conducted a pre- and post-survey study among AKI survivors who attended a post-discharge AKI Clinic. Setting: AKI Clinic at the University of Kentucky Medical Center (October 2016 to December 2017). Education about AKI was based on transformative learning theory and provided through printed materials and interdisciplinary interactions between patients/caregivers and nurses, pharmacists, and nephrologists. Patients: A total of 104 patients completed the survey and were included in the analysis. Measurements: Three survey questions were administered before and after the first AKI Clinic encounter: Question 1 (yes-no) for awareness, and questions 2 and 3 (Likert scale, 1 = lowest to 5 = highest) for self-rated knowledge and severity of AKI. Methods: Two mixed-model analysis of variance (ANOVA) was used for between-group (AKI severity) and within-group (pre- and post-encounter) comparisons. Logistic regression was used to examine parameters associated with the within-group change in self-perceived knowledge. Results: Twenty-two out of 104 (21%) patients were not aware of their AKI diagnosis before the clinic encounter. Patients’ self-ratings of their AKI knowledge significantly increased after the first AKI Clinic encounter (mean ± SEM: pre-visit = 1.94 ± 0.12 to post-visit = 3.88 ± 0.09, P = .001), even after adjustment for age, gender, Kidney Disease Improving Global Outcomes (KDIGO) severity stage, or poverty level. Patients with AKI stage 3 self-rated their AKI as more severe than patients with AKI stage 1 or 2. Limitations: Our study population may not be representative of the general AKI survivor population. Administered surveys are subject to response-shift bias. Conclusions: Patients’ self-perceived knowledge about AKI significantly increased following the first post-discharge AKI Clinic encounter that included interdisciplinary education. This is the first survey study examining self-perceived AKI knowledge in AKI survivors. Further examination of AKI literacy in survivors of AKI and its effect on post-AKI outcomes is needed. Trial registration: Not applicable.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Survey Study of Self-Rated Patients’ Knowledge About AKI in a Post-Discharge AKI Clinic

Ortiz-Soriano

Alcorn

et al. 2019

Can J Kidney Health Dis

Self Cite

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“… 57 Follow-up recommendations ( Figure 1 ) 31 have been proposed that could be integrated into a KDIGO guideline revision. Although it has been suggested that patients be screened at hospital discharge or seen within 1 month of AKI diagnosis, 58 there is no consensus on the optimal strategy and duration of follow-up to improve short- and long-term outcomes.…”

Section: Aki Risk Stratification and Assessmentmentioning

confidence: 99%

Controversies in acute kidney injury: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference

Ostermann

Bellomo

Burdmann

et al. 2020

Kidney International

314

230

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I n 2012, Kidney Disease: Improving Global Outcomes (KDIGO) published a guideline on the classification and management of acute kidney injury (AKI). 1 Since then, new evidence has emerged that has important implications for clinical practice. Large epidemiology studies and risk profiles for AKI have become available in adults and children, such as the AKI-Epidemiologic Prospective Investigation (AKI-EPI) study, 2 the 0by25 Initiative, 3 the Southeast Asia-AKI (SEA-AKI) study, 4 and the Assessment of Worldwide Acute Kidney Injury, Renal Angina, and Epidemiology (AWARE) 5 and Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) 6 studies. The effectiveness of the KDIGO recommendations in preventing AKI has been confirmed in small single-center randomized controlled trials (RCTs), such as the Prevention of AKI (PrevAKI) 7 and the

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“…The overall incidence of AKI is estimated to be 0.2-0.3%, the incidence of AKI in hospitalized patients is 10%, the incidence in intensive care units is 22-67% and the mortality rate is as high as 50-80% (2). In addition, the overall mortality rate of AKI is 60% in adults and 57-66% in children (3). In the USA, ~300,000 individuals succumb to AKI each year.…”

Section: Introductionmentioning

confidence: 99%

Thioredoxin relieves lipopolysaccharide‑induced acute kidney injury in mice by reducing inflammation, oxidative stress and apoptosis

Wang

Zhang

Lu³

2021

Exp Ther Med

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Acute kidney injury (AKI) is a serious disease with rapid onset and a high mortality rate. It is therefore particularly important to identify a suitable method for treating AKI. Thioredoxin (Trx) is a potent anti-inflammatory and anti-oxidant protein that is prevalent in living organisms. The aim of the present study was to facilitate the clinical treatment of AKI via the study of Trx. Lipopolysaccharide (LPS) was used to construct an AKI model in mice and the mice were pre-treated with Trx to examine its effect on AKI. In addition, human renal tubular epithelial HK-2 cells were cultured and stimulated with Trx to examine its effect on inflammation, levels of oxidative stress and apoptosis in the HK-2 cells. The NF-κB signaling pathway is a classical inflammation-related pathway and the mechanism of Trx was investigated by evaluating the association between Trx and the NF-κB signaling pathway. Trx treatment reduced LPS-induced levels of inflammation, oxidative stress and apoptosis in the HK-2 cells. The activity of NF-κB signaling pathway was increased in LPS-induced HK-2 cells, while Trx treatment effectively reduced NF-κB signaling pathway activity. In addition, Trx treatment significantly reduced LPS-induced mouse AKI in vivo, which was characterized by a decrease in inflammatory factors in mouse serum, a decrease in AKI-associated molecules in mouse urine and a decrease in oxidative stress levels in mouse kidney tissue samples. Trx treatment reduced inflammation, levels of oxidative stress and apoptosis in HK-2 cells by inhibiting the NF-κB signaling pathway, thereby alleviating LPS-induced mouse AKI.

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Care of the Acute Kidney Injury Survivor

Cited by 6 publications

References 21 publications

A Survey Study of Self-Rated Patients’ Knowledge About AKI in a Post-Discharge AKI Clinic

A Survey Study of Self-Rated Patients’ Knowledge About AKI in a Post-Discharge AKI Clinic

Controversies in acute kidney injury: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Conference

Thioredoxin relieves lipopolysaccharide‑induced acute kidney injury in mice by reducing inflammation, oxidative stress and apoptosis

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