Quality of Care for Acute Kidney Disease: Current Knowledge Gaps and Future Directions
Journal
Kidney International Reports
Journal Volume
5
Journal Issue
10
Pages
1634-1642
Date Issued
2020
Author(s)
Liu K.D.
Forni L.G.
Heung M.
Kellum J.A.
Mehta R.L.
Ronco C.
Kashani K.
Rosner M.H.
Haase M.
Koyner J.L.
Mehta R.
Acute Disease Quality Initiative Investigators
Abstract
Acute kidney injury (AKI) and acute kidney disease (AKD) are common complications in hospitalized patients and are associated with adverse outcomes. Although consensus guidelines have improved the care of patients with AKI and AKD, guidance regarding quality metrics in the care of patients after an episode of AKI or AKD is limited. For example, few patients receive follow-up laboratory testing of kidney function or post-AKI or AKD care through nephrology or other providers. Recently, the Acute Disease Quality Initiative developed a consensus statement regarding quality improvement goals for patients with AKI or AKD specifically highlighting efforts regarding quality and safety of care after hospital discharge after an episode of AKI or AKD. The goal is to use these measures to identify opportunities for improvement that will positively affect outcomes. We recommend that health care systems quantitate the proportion of patients who need and actually receive follow-up care after the index AKI or AKD hospitalization. The intensity and appropriateness of follow-up care should depend on patient characteristics, severity, duration, and course of AKI of AKD, and should evolve as evidence-based guidelines emerge. Quality indicators for discharged patients with dialysis requiring AKI or AKD should be distinct from end-stage renal disease measures. Besides, there should be specific quality indicators for those still requiring dialysis in the outpatient setting after AKI or AKD. Given the limited preexisting data guiding the care of patients after an episode of AKI or AKD, there is ample opportunity to establish quality measures and potentially improve patient care and outcomes. This review will provide specific evidence-based and expert opinion–based guidance for the care of patients with AKI or AKD after hospital discharge. ? 2020 International Society of Nephrology
Subjects
acute kidney injury; outcomes; quality; recovery
SDGs
Other Subjects
acute kidney failure; care bundle; comorbidity; consensus; dialysis; end stage renal disease; evidence based practice; follow up; health care quality; health care system; hospital discharge; human; kidney disease; kidney function; outpatient care; patient assessment; patient care; patient safety; pharmaceutical care; primary medical care; Review; total quality management
Publisher
Elsevier Inc.
Type
review