Babroudi Seda, Weiner Daniel E
Division of Nephrology, Tufts Medical Center, Boston, MA.
Division of Nephrology, Tufts Medical Center, Boston, MA.
Adv Kidney Dis Health. 2025 Mar;32(2):205-216. doi: 10.1053/j.akdh.2024.10.002.
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.
急性肾损伤（AKI）的全球发病率正在上升。AKI与短期和长期风险相关，包括慢性肾脏病和肾衰竭风险增加、心血管事件以及全因死亡。本综述总结了现有的出院后AKI护理指南，解读了AKI幸存者护理模式的现有证据状况，包括肾脏病专科和多学科团队干预措施，并详细介绍了美国接受门诊透析的AKI幸存者的卫生政策情况。本综述的主要发现是，支持特定出院后AKI护理干预措施的证据非常有限，导致国家和国际肾脏病学会针对AKI幸存者提出基于共识的不精确实践建议。这项工作的主要意义在于强调迫切需要开展更多研究，评估不同护理模式对有维持性透析、肾病进展、再次住院和死亡高风险的AKI幸存者的疗效，以设计出改善患者预后的基于价值的护理模式和临床干预措施。
