Currently, there is a lack of evidence to guide optimal care for acute kidney injury (AKI) survivors. Therefore, post-discharge care by a multidisciplinary care team (MDCT) may improve these outcomes. This study aimed to demonstrate the outcomes of implementing comprehensive care by a MDCT in severe AKI survivors. This study was a randomized controlled trial conducted between August 2018 to January 2021. Patients who survived severe AKI stage 2–3 were enrolled and randomized to be followed up with either comprehensive or standard care for 12 months. The comprehensive post-AKI care involved an MDCT (nephrologists, nurses, nutritionists, and pharmacists). The primary outcome was the feasibility outcomes; comprising of the rates of loss to follow up, 3-d dietary record, drug reconciliation, and drug alert rates at 12 months. Secondary outcomes included major adverse kidney events, estimated glomerular filtration rate (eGFR), and the amount of albuminuria at 12 months. Ninety-eight AKI stage 3 survivors were enrolled and randomized into comprehensive care and standard care groups (49 patients in each group). Compared to the standard care group, the comprehensive care group had significantly better feasibility outcomes; 3-d dietary record, drug reconciliation, and drug alerts (p < 0.001). The mean eGFR at 12 months were comparable between the two groups (66.74 vs. 61.12 mL/min/1.73 m2, p = 0.54). The urine albumin: creatinine ratio (UACR) was significantly lower in the comprehensive care group (36.83 vs. 177.70 mg/g, p = 0.036), while the blood pressure control was also better in the comprehensive care group (87.9% vs. 57.5%, p = 0.006). There were no differences in the other renal outcomes between the two groups. Comprehensive care by an MDCT is feasible and could be implemented for severe AKI survivors. MDCT involvement also yields better reduction of the UACR and better blood pressure control. Trial registration Clinicaltrial.gov: NCT04012008 (First registered July 9, 2019).

中文翻译：

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严重急性肾损伤幸存者的综合护理与标准护理，一项随机对照试验

目前，缺乏证据来指导急性肾损伤（AKI）幸存者的最佳护理。因此，多学科护理团队 (MDCT) 的出院后护理可能会改善这些结果。本研究旨在展示通过 MDCT 对严重 AKI 幸存者实施综合护理的结果。这项研究是一项随机对照试验，于 2018 年 8 月至 2021 年 1 月期间进行。从严重 AKI 2-3 期幸存的患者被纳入并随机接受为期 12 个月的综合或标准护理随访。AKI 后的综合护理涉及 MDCT（肾脏病学家、护士、营养师和药剂师）。主要结果是可行性结果；包括失访率、3 天饮食记录、药物协调率和 12 个月时的药物警报率。次要结局包括主要肾脏不良事件、估计肾小球滤过率 (eGFR) 和 12 个月时的蛋白尿量。98 名 AKI 3 期幸存者被纳入并随机分为综合护理组和标准护理组（每组 49 名患者）。与标准护理组相比，综合护理组的可行性结果明显更好；3 d 饮食记录、药物协调和药物警报 (p < 0.001)。12 个月时两组的平均 eGFR 相当（66.74 vs. 61.12 mL/min/1.73 m2，p = 0.54）。综合护理组的尿白蛋白：肌酐比值（UACR）显着较低（36.83 vs. 177.70 mg/g，p = 0.036），而综合护理组的血压控制也更好（87.9% vs. 57.5） ％，p = 0.006）。两组之间的其他肾脏结果没有差异。MDCT 的综合护理是可行的，可以对严重 AKI 幸存者实施。MDCT 的参与还可以更好地降低 UACR 并更好地控制血压。试验注册 ClinicalTrial.gov：NCT04012008（首次注册于 2019 年 7 月 9 日）。