Short and long-term prognosis in acute kidney injury

The first three papers in this continuing medical education series on acute kidney injury (AKI) discussed the epidemiology of AKI, the diagnostic approach and the non-dialytic and dialytic interventions in patients with AKI [1-3], respectively. In this fourth and last paper we describe the short and long-term prognosis of these patients. The acute patient mortality remains unacceptably high in particular when AKI occurs in a critically ill patient. However, also outside the intensive care unit, every episode of AKI – mild or not - is not only associated with short-term but also long-term adverse outcomes. It has recently become clear that even if the patient survives and is discharged from the hospital, some of the consequent adverse effects of AKI are related to incomplete or no recovery of renal function. Some of these long-term consequences of AKI leading to chronic kidney disease (CKD) are discussed in this paper with emphasis on data obtained in low-income countries. The necessary long-term renal follow up of AKI survivors imposes an additional burden on the overall health care system in these countries