Acute kidney injury

If recovery of function is complete and a normal glomerular filtration rate is re-established with no evidence of residual renal injury, no renal follow-up is required.

If the patient is left with residual chronic kidney disease (CKD) after AKI, nephrologist follow-up is recommended with interventions based on stage of CKD.[164]Cerdá J, Liu KD, Cruz DN, et al. Promoting kidney function recovery in patients with AKI requiring RRT. Clin J Am Soc Nephrol. 2015 Oct 7;10(10):1859-67. http://www.ncbi.nlm.nih.gov/pubmed/26138260?tool=bestpractice.com

The National Kidney Foundation KDOQI guidelines include recommendations regarding the management of patients who have developed CKD subsequent to AKI.[165]Kidney Disease: Improving Global Outcomes (KDIGO). 2012 clinical practice guideline for the evaluation and management of chronic kidney disease (CKD). Kidney Int Suppl. 2013 Jan;3(1):1-150. https://kdigo.org/wp-content/uploads/2017/02/KDIGO_2012_CKD_GL.pdf Management of chronic intrinsic renal diseases (e.g., glomerulonephritis and vasculitis) requires nephrologist intervention to manage therapies including corticosteroids, cytotoxic drugs, and immune-modifying drugs. Adverse effects and toxicities require close observation.