ESPN 50th Annual Meeting

ESPN 2017

Lifelong Follow Up Post AKI in PICU


Historically across the EMEESY network there was no defined pathway for follow up post AKI. In 2014 a new pathway was introduced. Initially this was for all patients receiving RRT for AKI within PICU, for 5 years post AKI. This has now been lengthened to lifelong and has been extended to all stage 3 AKI. Growing evidence suggests there is increased risk of developing CKD post AKI1,2. We also know CKD is a progressive, yet modifiable disease. By offering this lifelong follow up pathway of care, we hope to modify the progression of the disease post AKI.

Material and methods:

Patients have been identified for follow up by local link nurses within each centre. This has been aided by the introduction of the new PICANet Renal audit, as each centre within the network is a pilot site for this audit. This follow up pathway involves: • Creatinine check year 1 & 5 • Annual BP check • Annual urine dipstick (+/- protein:creatinine ratio) • Formal GFR 1 yr and 5yr • For 5 years this will take place within their local hospital across the network clinics and outcomes collated within the Regional Tertiary Nephrology Centre. After this, if there are no other concerns, the child will be discharged to their GP for ongoing lifelong follow up.


Within the first 3 years of this project 37 patients have been referred for follow up across the EMEESY network. The data and information collated thus far is limited, not allowing us to draw conclusions at this point.


In time through adapting our systems for identification of AKI across the network we hope this pathway will become ingrained in everyday practice. The ultimate aim would be to lessen the severity of CKD post AKI, the lifelong follow up of this cohort of patients will allow this to be assessed.