Worse AKI Outcomes Linked to Delayed Nephrology Referral

Share this article:

Delayed nephrology consultation (NC) is associated with greater mortality and increased risk of dependence at hospital discharge among critically patients with acute kidney injury (AKI), according to researchers.

Veronica Torres Costa e Silva, MD, of the University of São Paulo School of Medicine in São Paulo, Brazil, and colleagues studied 366 AKI patients, of whom 196 (53.6%) had an NC. Sixty-eight NC patients (35%) had a delayed NC and 128 (65%) had an early NC. The researchers defined delayed and early NC as occurring before and more than 48 hours after the day of AKI diagnosis, respectively.

A total of 248 patients (67.8%) died in the hospital and 115 (31.4%) required dialysis at hospital discharge. The delayed NC group had a fourfold and threefold increased odds of in-hospital mortality and dialysis dependence at hospital discharge, respectively, compared with the early NC group, the investigators reported in PLOS One (2013;8:e70482). Delayed NC patients also had significantly increased ICU lengths of stay and significantly longer mechanical ventilation support compared with the early NC group (19.0 vs. 13.5 days and 16.5 vs. 10.0 days, respectively).

Although NC patients had a greater severity of illness compared with non-NC patients, their mortality rates were similar after adjusting for propensity score.

Share this article:
You must be a registered member of RUN to post a comment.
close

Next Article in Acute Kidney Injury

More in Acute Kidney Injury

Stroke Risk Higher in Patients Who Recover from AKI

Stroke Risk Higher in Patients Who Recover from ...

Taiwan study reveals a 25% increased risk of stroke among patients who recover from dialysis-requiring acute kidney injury.

Statins May Lower Risk of Contrast-Induced AKI

Statins May Lower Risk of Contrast-Induced AKI

Meta-analysis reveals a 46% decreased risk of contrast-induced acute kidney injury in patients undergoing coronary catheterization.

Where AKI Develops Affects Death Risk

Where AKI Develops Affects Death Risk

Patients are more likely to die if their acute kidney injury was acquired in the hospital rather than in the community.