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Nephrologist follow-up improves mortality of severe acute kidney injury patients
Date:4/30/2013

TORONTO, April 30, 2013Patients with acute kidney injury who see a nephrologist within 90 days of being discharged from a hospital have a 24 per cent lower risk of dying than those who do not see a kidney specialist, a new study has found.

The benefit of seeing a nephrologist was most pronounced in individuals who had not previously seen a nephrologist, and likely had new onset kidney disease, according to the study by Dr. Ziv Harel of St. Michael's Hospital.

The study appears in the May issue of the journal Kidney International.

Acute kidney injury (acute renal failure or rapid loss of kidney function) is a common complication of hospitalized patients. Those patients have a 40 per cent risk of dying in the two years after the initial hospitalization.

The study found the risk of death increases with the severity of the injury, with patients who require dialysis having the highest risk of death. This risk persists even after the patients recover from their acute kidney injury and no longer require dialysis.

Dr. Harel said previous studies have found similar results for other life-threatening conditions such as myocardial infarctions, heart failure and asthma. Patients discharged from hospital following a heart attack who saw a cardiologist shortly afterward had a decreased mortality rate after two years.

However, only eight per cent of patients hospitalized with acute kidney injury requiring dialysis see a nephrologist within a year if discharge. Few studies have examined the impact of early nephrology follow-up on mortality. Dr. Harel's study examined 1,184 patients in Ontario who received follow-up care and matched them with similar patients who did not.

Patients who had a follow-up visit with a nephrologist were more likely to have pre-existing chronic kidney disease, hypertension, previous visits to a nephrologist and a kidney biopsy before hospitalization. They also had lower rates of sepsis, mechanical ventilation, card
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Contact: Leslie Shepherd
shepherdl@smh.ca
416-864-6094
St. Michael's Hospital
Source:Eurekalert

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