Chapter 2 AKI
2.2 Association of AKI with mortality & morbidity
Chertow et al (2005): 
: association of AKI with mortality.
Sawhney et al (2017): : AKI predicts 90-day re-adnission; pulmonary oedema is commonest cause of re-admission.
Brar et al (2018): : observational study of ~ 45,000 patients hospitalised with AKI in Canada. Prescription of RASi in the 6 months after AKI was associated with lower subsequent mortality but higher risk of hospital re-admission for a renal cause.
2.3 Other trials in AKI
A well-conducted RCT dispelled the myth that dopamine could be used for renoprotection in critically ill patients:
Bellomo et al. (2000): 
- low-dose dopamine infusion vs. placebo in critically ill patients. No protection from AKI in dopamine group.
What is the effect of a complex, multi-modal intervention?
TACKLING AKI (2019): - pragmatic, step-wedged RCT in ~24,000 AKI episodes: increase in AKI recognition and reduced length-of-stay but no effect on 30 day mortality and no attempt to examine longer-term outcomes.
Sick day rules are not straightforward:
Doerfler et al (2019): - 20 patients tested on ability to apply “sick day rules” to common scenarios. 95% of participants made errors in selecting medicines to hold.