# Post-Discharge Nephrology Follow-up for Improved Outcomes

> **NIH NIH U01** · JOHNS HOPKINS UNIVERSITY · 2024 · $630,256

## Abstract

PROJECT SUMMARY/ABSTRACT
Acute kidney injury (AKI) is a common complication experienced by roughly 20% of adult patients during
hospitalization. AKI is associated with long-term adverse outcomes including cardiovascular disease and
death, as well as chronic kidney disease (CKD). Although serum creatinine may improve or normalize after an
episode of AKI, the biological processes of injury, repair, and fibrosis may continue for months afterwards; thus
during this time period, interventions can be implemented to improve long-term outcomes. Indeed, early post-
discharge follow-up with a nephrologist after severe AKI has been associated with a 25% reduction in mortality
in pilot trials. The overall objective of this multicenter clinical trial is to definitively evaluate the impact of
systematic post-discharge nephrology follow-up among patients with in-hospital AKI in a dedicated transitional
care clinic after acute kidney injury (TCC-AKI) and compare it with the standard of care. The rationale is that
the first few months after hospital discharge represent a critical window of time in which medical interventions
may have a significant impact on long-term kidney outcomes. This intervention will consist of telemedicine or
in-person visits in which nephrologists will address several key domains of patient care that can influence long-
term clinical outcomes, including blood pressure management, medication reconciliation, cardiovascular health
assessment, and patient counseling. We will emphasize appropriate care management targets for several
comorbid risk factors. The overarching hypothesis is that timely longitudinal follow-up at the TCC-AKI post-
discharge in patients with KDIGO Stages 2 and 3 AKI will result in improved intermediate and long-term clinical
outcomes compared to usual care, with better patient-reported outcomes as well. The overall objective will be
achieved by pursuing 3 specific aims: 1) to recruit patients with KDIGO stages 2 and 3 AKI during
hospitalization to a randomized clinical trial of post-discharge AKI follow-up; 2) to ascertain intermediate
outcomes in patients receiving post-discharge AKI follow-up compared to those receiving usual care; and 3) to
ascertain long-term outcomes of post-discharge AKI follow-up compared to those receiving usual care. Under
Aim 1, patients will be recruited into this study for randomization to systematic AKI follow-up in a TCC-AKI.
Under Aim 2, intermediate outcomes, including recurrent AKI and hospitalizations will be evaluated. Under Aim
3, long-term outcomes including CKD incidence, CKD progression, and mortality will be assessed. The
research proposed here is innovative for its multidisciplinary approach, use of cutting-edge techniques,
integration of telemedicine for clinical use, and development of a systematic approach to post-discharge AKI
follow-up. This work will be significant because rigorously conducted randomized studies and translational
research studies are needed to evaluate th...

## Key facts

- **NIH application ID:** 10909397
- **Project number:** 5U01DK129984-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Chirag R Parikh
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $630,256
- **Award type:** 5
- **Project period:** 2021-07-19 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10909397

## Citation

> US National Institutes of Health, RePORTER application 10909397, Post-Discharge Nephrology Follow-up for Improved Outcomes (5U01DK129984-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10909397. Licensed CC0.

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