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Background <p>Children experiencing acute kidney injury (AKI) are at heightened risk of developing chronic kidney disease (CKD). While identifying patients at high-risk for CKD after AKI early is crucial, indefinite follow-up may strain healthcare resources. We assessed potential predictive factors for CKD following AKI to guide safe discontinuation of follow-up after one year.</p> Methods <p>We evaluated outcomes of children with AKI prospectively. We assessed for associations between hospitalization and first-year outpatient data with presence of estimated glomerular filtration rate (eGFR) &lt; 90 mL/min/1.73 m<sup>2</sup> or CKD (eGFR &lt;60 or 60–90 with proteinuria) at 3–5 years after AKI.</p> Results <p>96 patients were included. Patients with eGFR &lt;90 had longer AKI duration, higher prevalence of AKI stage 3, and received more KRT. No patient with CKD at 3–5 years was CKD-free in the first year of follow-up and only three patients with normal eGFR during the first year post-AKI had abnormal eGFR at 3–5 years; all had complex medical diseases which would necessitate kidney function monitoring as standard of care.</p> Conclusions <p>Our data suggest patients without eGFR&lt;90/CKD during the first year post-AKI have low CKD risk in the following 2–4 years and may be safely discharged from nephrology clinics after one year of follow-up.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Patients without eGFR &lt;90/CKD during the first year post-AKI have low CKD risk in the following 2–4 years.</p> </ItemContent> <ItemContent> <p>Lack of CKD in the first year post-AKI is maintained up to 3–5 years after the original episode.</p> </ItemContent> <ItemContent> <p>Patients without eGFR &lt;90/CKD in the first year post-AKI can be safely discharged from nephrology care.</p> </ItemContent> </UnorderedList></p>

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Long-term follow-up strategies for children after severe acute kidney injury

  • 期刊论文

  • 发表日期：

    2025年3月7日

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  • Giovanni Ceschia,
  • Donna J. Claes,
  • Kelli A. Krallman,
  • Michaela Collins,
  • Stuart L. Goldstein

摘要

Background

Children experiencing acute kidney injury (AKI) are at heightened risk of developing chronic kidney disease (CKD). While identifying patients at high-risk for CKD after AKI early is crucial, indefinite follow-up may strain healthcare resources. We assessed potential predictive factors for CKD following AKI to guide safe discontinuation of follow-up after one year.

Methods

We evaluated outcomes of children with AKI prospectively. We assessed for associations between hospitalization and first-year outpatient data with presence of estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 or CKD (eGFR <60 or 60–90 with proteinuria) at 3–5 years after AKI.

Results

96 patients were included. Patients with eGFR <90 had longer AKI duration, higher prevalence of AKI stage 3, and received more KRT. No patient with CKD at 3–5 years was CKD-free in the first year of follow-up and only three patients with normal eGFR during the first year post-AKI had abnormal eGFR at 3–5 years; all had complex medical diseases which would necessitate kidney function monitoring as standard of care.

Conclusions

Our data suggest patients without eGFR<90/CKD during the first year post-AKI have low CKD risk in the following 2–4 years and may be safely discharged from nephrology clinics after one year of follow-up.

Impact

Patients without eGFR <90/CKD during the first year post-AKI have low CKD risk in the following 2–4 years.

Lack of CKD in the first year post-AKI is maintained up to 3–5 years after the original episode.

Patients without eGFR <90/CKD in the first year post-AKI can be safely discharged from nephrology care.