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Publications

Journal Article Ahead of print

PubMed: 42374257 DOI: 10.1186/s12882-026-05108-4

Nephrologist follow-up improves outcomes after hospitalization with acute kidney injury.

BMC Nephrol

Authors: Yi-Ran Tu, Chen-Chia Lee, Pei-Chun Fan, Kun-Hua Tu, Jia-Jin Chen, Ya-Lien Cheng, Chao-Yu Chen, Victor Chien-Chia Wu, Vin-Cent Wu, Chih-Hsiang Chang

Affiliations

  • Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, No.5, Fusing St. Gueishan District,, Taoyuan City, 333423, Taiwan.
  • Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, No.5, Fusing St. Gueishan District,, Taoyuan City, 333423, Taiwan. Graduate Institute of Clinical Medicine Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Graduate Institute of Clinical Medicine Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Department of Cardiology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.
  • Department of Nephrology, National Taiwan University Hospital, Taipei, Taiwan.
  • Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, No.5, Fusing St. Gueishan District,, Taoyuan City, 333423, Taiwan. Graduate Institute of Clinical Medicine Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Abstract

INTRODUCTION

Acute kidney injury (AKI) is a common medical condition for patients during hospitalization and is associated with long-term sequelae. The incidence of AKI is increasing, whereas in-hospital mortality from the condition is decreasing. We compared outcomes following discharge in patients with AKI between those who received follow-up with nephrologists and those who only received routine follow-up (i.e., follow-up not at the nephrology department).

MATERIALS AND METHODS

This retrospective cohort study identified 66,859 AKI survivors with discharge eGFR values of less than 60 mL/min/1.73 m² from January 1, 2004, to June 30, 2019. Patients were categorized by follow-up department after discharge into nephrology and non-nephrology groups during the 6-month exposed period. The clinical outcomes included all-cause death, cardiovascular death, heart failure, readmission with AKI, and new-onset dialysis.

RESULTS

AKI survivors who received 3 years of follow-up at a nephrology department had significantly lower rates of all-cause death (hazard ratio [HR]: 0.91; 95% CI: 0.87 to 0.96), cardiovascular death (HR: 0.82; 95% CI: 0.75 to 0.90), and readmission with AKI (HR: 0.82; 95% CI: 0.77 to 0.87) but higher rates of heart failure (HR: 1.13; 95% CI: 1.05 to 1.21) and new-onset dialysis (HR: 1.67; 95% CI: 1.43 to 1.95) than did those who received routine follow-up at non-nephrology department.

CONCLUSIONS

Following discharge, patients with AKI during hospitalization, especially severe AKI, are at significantly lower risk of all-cause death, cardiovascular death, and readmission with AKI if they receive follow-up at a nephrology department compared with non-nephrology follow-up.

MeSH

Kidney Diseases, Hospitalization, Heart Failure, Heart, Nephrologists, Hospital Mortality, Kidney, Nephrology, Acute Kidney Injury