{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:31:09Z","timestamp":1777505469803,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Survivors of acute kidney injury (AKI) are at a high risk for cardiovascular complications. An underrecognition of this risk may contribute to the low utilization of relevant guideline-based therapies in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We sought to assess accordance with guideline-based recommendations for survivors of AKI with diabetes, coronary artery disease (CAD), and preexisting chronic kidney disease (CKD) in a post-AKI clinic, and identify factors that may be associated with guideline accordance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Post-AKI clinics at 2 tertiary care centers in Ontario, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>We included adult patients seen in both post-AKI clinics between 2013 and 2019 who had at least 2 clinic visits within 24 months of an index AKI hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>We assessed accordance to recommendations from the most recent North American and international guidelines available at the time of study completion for diabetes, CAD, and CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We compared guideline accordance between visits using the Cochran Mantel Haenszel test. We used multivariable Poisson regression to identify prespecified factors associated with accordance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 213 eligible patients, 192 (90%) had Kidney Disease Improving Global Outcomes Stage 2-3 AKI, 91 (43%) had diabetes, 76 (36%) had CAD, and 88 (41%) had preexisting CKD. From the first clinic visit to the second, there was an increase in angiotensin-converting enzyme inhibitor\/angiotensin receptor blocker (ACE-I\/ARB) use across all disease groups\u2014from 33% to 46% ( P = .028) in patients with diabetes, from 30% to 57% ( P = .002) in patients with CAD, and from 16% to 35% ( P &lt; .001) in patients with preexisting CKD. Statin use increased in patients with preexisting CKD from 64% to 71% ( P = .034). Every 25 \u03bcmol\/L rise in the discharge serum creatinine was associated with a 19% (95% confidence interval [CI], 8%-28%) and 12% (95% CI, 2%-21%) lower likelihood of being on an ACE-I\/ARB in patients with diabetes and preexisting CKD, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations:<\/jats:title>\n                    <jats:p>The study lacked a comparison group that received usual care. The small sample and multiple comparisons make false positives possible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is room to improve guideline-based cardiovascular risk factor management in survivors of AKI, particularly ACE-I\/ARB use in patients with an elevated discharge serum creatinine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20543581221103682","type":"journal-article","created":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T08:35:04Z","timestamp":1655195704000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Use of Guideline-Based Therapy for Diabetes, Coronary Artery Disease, and Chronic Kidney Disease After Acute Kidney Injury: A Retrospective Observational Study"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7077-1076","authenticated-orcid":false,"given":"Sunchit","family":"Madan","sequence":"first","affiliation":[{"name":"Division of Nephrology, St. Joseph\u2019s Healthcare Hamilton, McMaster University, Hamilton, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick A.","family":"Norman","sequence":"additional","affiliation":[{"name":"Kingston General Health Research Institute, Kingston, ON, Canada"},{"name":"Department of Public Health Sciences, Queen\u2019s University, Kingston, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron","family":"Wald","sequence":"additional","affiliation":[{"name":"Division of Nephrology, St. Michael\u2019s Hospital, University of Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier A.","family":"Neyra","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Bone and Mineral Metabolism, Department of Internal Medicine, University of Kentucky, Lexington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Meraz-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Division of Nephrology, St. Michael\u2019s Hospital, University of Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8618-4538","authenticated-orcid":false,"given":"Ziv","family":"Harel","sequence":"additional","affiliation":[{"name":"Division of Nephrology, St. Michael\u2019s Hospital, University of Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1843-6131","authenticated-orcid":false,"given":"Samuel A.","family":"Silver","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Kingston Health Sciences Centre, Queen\u2019s University, Kingston, ON, 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