Abstract: FR-PO0423
Nephrologist Follow-Up Reduces Recurrent AKI in AKI Survivors: A Propensity Score-Matched Study
Session Information
- AKI: Biomarkers, Diagnostics, and Risk Prediction
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Thanapongsatorn, Peerapat, Thammasat University Hospital, Khlong Nueng, Pathumthani, Thailand
- Jindapateep, Patharasit, Thammasat University Hospital, Khlong Nueng, Pathumthani, Thailand
- Tantiyavarong, Pichaya, Thammasat University Hospital, Khlong Nueng, Pathumthani, Thailand
Background
Survivors of moderate-to-severe acute kidney injury (AKI) face a high risk of recurrent AKI, which is linked to chronic kidney disease (CKD) progression and mortality. While guidelines suggest post-discharge surveillance, the clinical impact of specialized nephrology follow-up remains uncertain. This study evaluated whether nephrologist follow-up reduces recurrent AKI incidence compared to usual care.
Methods
We conducted a retrospective cohort study at Thammasat University Hospital, Thailand, including adults discharged after KDIGO stage 2–3 AKI between January 2018 and December 2024, with a 1-year follow-up period. The primary outcome was recurrent AKI within 1 year. Secondary outcomes included major adverse kidney events (MAKE), CKD progression, readmission, and mortality. Propensity score matching (1:1) was used to balance baseline characteristics, and outcomes were analyzed using cause-specific hazard models.
Results
Among 1,267 survivors discharged after stage 2–3 AKI, 279 (22.0%) received consistent nephrologist follow-up, while 988 (78.0%) received usual care. Before matching, the nephrologist group had a significantly higher comorbidity burden and more severe index AKI. After matching (n = 512), nephrologist follow-up was associated with a 30% lower risk of recurrent AKI (47.3 vs. 69.4 events per 100 patient-years; HR 0.70, 95% CI 0.53–0.92). The nephrologist group also had a significantly lower risk of all-cause readmission (HR 0.66, 95% CI 0.51–0.86). However, no difference in MAKE, mortality, and CKD progression between both groups.
Conclusion
Among survivors of severe AKI, nephrologist follow-up was associated with a lower risk of recurrent AKI and hospital readmission. These benefits are likely driven by better nephrotoxin avoidance and enhanced surveillance, supporting structured post-AKI care pathways.
Acknowledgment
This study was supported by Research Unit in Integrated Nephrology and Critical Care Nephrology from the Faculty of Medicine, Thammasat University.
Outcome after propensity matched score
| Outcomes | Event rate per 100 patient-years | HR (95%CI) | P-value |
| Recurrent AKI | 47.3 vs 69.4 | 0.7 (0.53-0.92) | 0.011 |
| MAKE | 15.8 vs 16.8 | 0.94 (0.61-1.47) | 0.78 |
| Mortality | 7.3 vs 10.4 | 0.71 (0.38-1.29) | 0.26 |
| CKD progression | 8.5 vs 5.2 | 1.64 (0.80-3.36) | 0.17 |
| RRT | 3.7 vs 0.8 | 4.4 (0.95-20.4 | 0.06 |
| Readmission | 55.5 vs 85.8 | 0.66 (0.51-0.86) | 0.002 |
AKI, acute kidney injury; CKD, chronic kidney disease; MAKE, major adverse kidney event; RRT, renal replacement therapy