Planning follow-up after AKI
All patients who experience AKI should have planned follow-up, as many remain at increased risk of adverse outcomes even when kidney function appears to have recovered.
- Episodes of AKI should be clearly documented and coded in the primary care record to inform future risk assessment, prescribing decisions, and ongoing care.
- Practices may find it helpful to use searchable systems or registers to support recall, medicines review, and prioritised follow-up, in line with NICE quality standards and local care pathways.
- Follow-up should be proportionate and individualised, taking account of AKI severity, degree of recovery, comorbidity (including heart failure and CKD), frailty, and the wider clinical and social context.
- NICE QS76 includes a specific statement on post-discharge review after AKI (within 3 months, or sooner for higher-risk people).
Post-AKI follow-up also provides an opportunity to agree a proactive plan for future episodes of acute illness, developed with the patient (and carers where relevant). This may include:
- a shared understanding of AKI risk,
- agreed thresholds and routes for escalation if the patient becomes unwell, and
- an individualised approach to medicines review or temporary adjustment during intercurrent illness where appropriate.
Especially for people living with frailty, multimorbidity, cognitive impairment, or complex social circumstances, kidney-focused actions should be aligned with broader care priorities using person-centred planning approaches and community-based supports.
AKI as a marker of future kidney risk
An episode of AKI should be regarded as a marker of increased long-term kidney and cardiovascular risk. Primary care has a key role in ensuring that kidney health is integrated into ongoing care, including assessment for new or progressive chronic kidney disease, review of urine albumin-creatine ratio (ACR) where appropriate, and alignment with existing long-term condition management.