{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T23:30:07Z","timestamp":1786491007272,"version":"build-2736575974"},"reference-count":66,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"NIHR Health and Social Care Delivery Research","award":["NIHR131948"],"award-info":[{"award-number":["NIHR131948"]}]},{"name":"NIHR Health and Social Care Delivery Research","award":["NIHR131948"],"award-info":[{"award-number":["NIHR131948"]}]},{"name":"NIHR Health and Social Care Delivery Research","award":["NIHR131948"],"award-info":[{"award-number":["NIHR131948"]}]},{"name":"NIHR Health and Social Care Delivery Research","award":["NIHR131948"],"award-info":[{"award-number":["NIHR131948"]}]},{"name":"NIHR Health and Social Care Delivery Research","award":["NIHR131948"],"award-info":[{"award-number":["NIHR131948"]}]},{"name":"NIHR Health and Social Care Delivery Research","award":["NIHR131948"],"award-info":[{"award-number":["NIHR131948"]}]},{"name":"NIHR Health and Social Care Delivery Research","award":["NIHR131948"],"award-info":[{"award-number":["NIHR131948"]}]},{"name":"NIHR Health and Social Care Delivery Research","award":["NIHR131948"],"award-info":[{"award-number":["NIHR131948"]}]},{"name":"NIHR Health and Social Care Delivery Research","award":["NIHR131948"],"award-info":[{"award-number":["NIHR131948"]}]},{"name":"NIHR Greater Manchester Patient Safety Research Collaboration"},{"name":"Manchester British Heart Foundation (BHF) Centre for Research Excellence","award":["RE\/24\/130017"],"award-info":[{"award-number":["RE\/24\/130017"]}]},{"name":"NIHR HealthTech Research Centre in Emergency and Acute Care","award":["NIHR205301"],"award-info":[{"award-number":["NIHR205301"]}]},{"name":"Leeds NIHR HealthTech Research Centre in Accelerated Surgical Care"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute kidney injury (AKI) is a clinical syndrome characterised by a sudden deterioration of kidney function. It is common and usually occurs as a complication of severe illness or major surgery. Despite the high risk of complications and a decade of improvement initiatives in the UK, little is known about the quality of post-discharge AKI care. Our population-based cohort study investigated adherence to guideline-recommended post-AKI care in general practices in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using English hospital admission data (2017\u20132021), we created a cohort of discharged patients (\u2265\u200918 years) with a hospital diagnostic code of AKI. Using linked Clinical Practice Research Datalink Aurum primary care data, we examined percentages of AKI episodes meeting the criteria of 14 guideline-recommended post-AKI care indicators, covering: AKI coding in primary care, post-discharge primary care contacts, kidney health and blood pressure monitoring, and guideline-indicated prescribing. Variations of indicator adherence according to patient characteristics were quantified using binomial mixed regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>209,222 patients (48.0% females; mean age 74.1 years) were included, representing 279,187 AKI inpatient episodes. Only 19.5% (95% CI 18.5\u201320.5) of episodes had AKI coded in primary care within 30 days of discharge, while 72.6% (95% CI 71.8\u201373.4) had a documented contact with general practice. At 90\u2009\u00b1\u200930 days after discharge, serum creatinine was measured in 34.2% (95% CI 33.7\u201334.8) of episodes, blood pressure in 34.6% (95% CI 34.0-35.1), and albumin-creatinine ratio in 4.2% (95% CI 4.0-4.4). Testing was less common amongst younger patients and those without comorbid conditions. Renin-angiotensin system inhibitor prescribing rates were low in patients likely to benefit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There are multiple missed opportunities for improving post-AKI care. Rates of measuring albuminuria were particularly low, despite its strong association with subsequent kidney and cardiovascular events. The limited post-AKI clinical activity amongst younger patients and those without comorbidities undermines the prevention and early intervention of chronic kidney diseases. Clearer discharge arrangements, including case-specific guidance on discharge summaries, and the development and evaluation of concerted implementation strategies spanning secondary and primary care are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12916-026-05042-0","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T23:02:25Z","timestamp":1786489345000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Examining variations in adherence to guideline-recommended post-acute kidney injury care in primary care in England: a population-based cohort study"],"prefix":"10.1186","volume":"24","author":[{"given":"Pearl L H","family":"Mok","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Sawhney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Blakeman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Carr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel A","family":"Elliott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robbie","family":"Foy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon DS","family":"Fraser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Kontopantelis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J P","family":"Lewington","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Mahboub-Ahari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Roderick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas M","family":"Selby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren M","family":"Ashcroft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"5042_CR1","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/S0140-6736(24)02385-7","volume":"405","author":"M Ostermann","year":"2025","unstructured":"Ostermann M, Lumlertgul N, Jeong R, See E, Joannidis M, James M. 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