Assessment of adult patients after acute kidney injury dispensary follow-up

Acute kidney injury (AKI) constitutes a significant clinical syndrome that is associated with a range of adverse outcomes. The relevance of this study arises from the limited literature on outpatient management of patients post-AKI in the Russian Federation, along with the heterogeneity in the syndrome’s classification. Objective. This study aims to evaluate the nosological structure of acute kidney injury observed in a nephrology hospital and to analyze the outpatient management of patients who have recovered from this condition. Materials and methods. A single-center, retrospective, registry-based observational study was conducted utilizing medical records of patients diagnosed with AKI who were admitted to the nephrology department at Ryazan Municipal Clinical Hospital No. 11 between January 1, 2023, and December 31, 2024. The inclusion criteria were as follows: individuals must be 18 years of age or older and meet the KDIGO criteria. Results. «Community-acquired» AKI was present in 65% of the cases. The predominant causes identified were acute interstitial nephritis associated with hemorrhagic fever with renal syndrome (25%) and complications arising from chronic kidney disease (CKD) (25%). In 32% of the cases, the etiology was undetermined. Outpatient follow-up was assessed for 36 of the 40 patients (90%). Only five patients returned for follow-up appointments after AKI, and all did so beyond the recommended three-day interval. Serum creatinine measurements were obtained in only 2 patients; glomerular filtration rate was not calculated in any patient, and serum LDL-C levels were not assessed. Evaluations by nephrologists were conducted for only 9 patients, and of these, only 5 received follow-up care after 3 months. During the outpatient follow-up, five patients died from various causes, and three experienced a subsequent episode of AKI. None of these patients was enrolled in the dispensary follow-up. Conclusions. In the outpatient management of patients following acute kidney injury (AKI), adherence to critical aspects of follow-up care—such as the timing of diagnostic evaluations, monitoring of health metrics, duration of surveillance, and prompt nephrology consultation—was inconsistent.