Discharge communication

When a patient is discharged following an episode of AKI, discharge documentation should clearly communicate the following AKI-specific information, alongside standard discharge content:

AKI episode

• Cause(s) of AKI
• Whether AKI was present on admission or hospital-acquired
• Highest AKI stage reached (Stage 1, 2, or 3)
• Key severity markers (e.g., critical care admission and/or kidney replacement therapy), if applicable

Medicines

• Medications stopped or dose-adjusted during AKI (e.g. ACEi/ARB, diuretics, other blood-pressure-lowering, or other drugs that can cause or exacerbate kidney injury)
  • Clear documentation of whether these were restarted prior to discharge, and
  • Specific instructions on medicines to restart, withhold, or review after discharge

Recovery status

• Serum creatinine at discharge, with comment on whether kidney function is stable, improving, or still evolving

Follow-up and responsibility

• Planned follow-up, including:
  • What tests are required
  • Expected timing and frequency
  • Who is responsible for arranging and reviewing results

As a minimum, longer-term kidney function review should be undertaken after AKI to assess recovery and identify new or worsening chronic kidney disease. This commonly includes serum creatinine and urine albumin-creatinine ratio (ACR) testing at 3–6 months.