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논문분류	춘계학술대회 초록집
제목	Long-Term Outcomes After Severe AKI Requiring CKRT: Rethinking the Role of Post-Discharge Nephrology Care
저자	Sei Hong Min
출판정보	2026; 2026(1):
키워드	Acute Kidney Injury, Chronic Kidney Disease, Disease Progression, Mortality, Referral and Consultation
초록	Objectives: The impact of outpatient nephrology follow-up after severe acute kidney injury (AKI) remains controversial. Although several studies have reported associations between nephrology follow-up and improved outcomes, prior studies primarily focused on dialysis independence as the renal outcome. Therefore, we sought to evaluate whether nephrology follow-up independently influences CKD progression after severe AKI requiring CKRT, using weighted analyses. Methods: We conducted a retrospective cohort study of survivors of severe AKI requiring CKRT. The primary renal outcome was 12-month chronic kidney disease (CKD) progression. Secondary outcomes included time-dependent mortality. Inverse probability of treatment weighting (IPTW) was applied using baseline covariates including demographic, comorbidity, and ICU variables. Mortality was analyzed using weighted time-dependent Cox regression. Early renal recovery slope was quantified to capture renal trajectory during the acute kidney disease (AKD) phase. Results: Among 569 survivors of severe AKI requiring CKRT, 448 patients with complete data were included in the weighted renal outcome analysis. Nephrology follow-up was associated with higher odds of CKD progression after IPTW adjustment (OR 2.58, 95% CI 1.69–3.93). When early recovery slope was added to the model, the association disappeared (OR 1.04, 95% CI 0.61–1.79). Early recovery slope independently predicted CKD progression (OR 0.0012, 95% CI 0.00029–0.00506). For mortality, weighted time-dependent Cox analysis demonstrated no significant survival benefit associated with nephrology follow-up (HR 0.73, 95% CI 0.42–1.28). Conclusion: Outpatient nephrology follow-up was not independently associated with improved long-term renal outcomes or mortality after adjustment for illness severity and early renal recovery slope . The absence of an independent association suggests that once early renal recovery trajectory is established, current outpatient nephrology follow-up may have limited ability to modify subsequent long-term renal outcomes. Our results imply that future models of outpatient nephrology follow-up should focus on earlier, trajectory-informed interventions during the AKD phase.
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