Thousands of patients in England are missing vital follow-up care after hospital discharge for acute kidney injury (AKI), according to research published in BMC Medicine by The University of Manchester. The study, funded by the National Institute for Health and Care Research and supported by the NIHR Patient Safety Research Collaboration, is the first major investigation of post-discharge AKI care across general practices in England.
AKI is a common clinical syndrome affecting up to 1 in 5 hospitalized patients, usually as a complication of severe illness or major surgery. One in 3 people with AKI experiences recurrent episodes. Even after hospital discharge, patients remain at high risk of poor outcomes including emergency readmissions, recurrent AKI, chronic kidney disease, and major adverse cardiovascular events.
Researchers analyzed health records from more than 209,000 patients discharged after AKI episodes across more than 1,400 general practices. They found that recommended clinical guidelines for continued follow-up care were often not followed. Only 19% of hospital AKI episodes were documented in primary care records within 30 days of discharge using recommended codes. The proportion was even smaller among patients younger than 60 and those who had major surgery.
Despite regular contact with primary care, many patients did not receive recommended blood and urine tests to assess kidney health, the study found. Younger individuals and those without documented health concerns were least likely to receive tests. Current clinical recommendations state that primary care should play a central role in supporting recovery and safe follow-up after AKI discharge.
The study concluded that improvements in sharing discharge information and follow-up care could help identify at-risk patients sooner and improve outcomes for those transitioning from hospital to community care. Researchers highlighted the need for greater adoption of kidney health strategies across both primary and secondary care settings.
