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Introduction: Survivors of acute kidney injury (AKI) are at high risk of progression to chronic kidney disease (CKD), for which drugs may be a modifiable risk factor. Methods: We conducted a population-based cohort study of Olmsted County, MN residents who developed AKI while hospitalized between January 1, 2006, and December 31, 2014, using Rochester Epidemiology Project data. Adults with a hospitalization complicated by AKI who survived at least 90 days after AKI development were included. Medical records were queried for prescription of potentially nephrotoxic medications over the 3 years after discharge. The primary outcome was de novo or progressive CKD defined by either a new diagnosis code for CKD or ≥30% decline in estimated glomerular filtration rate from baseline. The composite of CKD, AKI readmission, or death was also evaluated. Results: Among 2,461 AKI survivors, 2,140 (87%) received a potentially nephrotoxic medication during the 3 years following discharge. When nephrotoxic medication use was analyzed in a time-dependent fashion, those actively prescribed at least one of these drugs experienced a significantly higher risk of de novo or progressive CKD (HR 1.38: 95% CI: 1.24, 1.54). Similarly, active potentially nephrotoxic medication use predicted a greater risk of the composite endpoint of CKD, AKI readmission, or death within 3 years of discharge (HR 1.41: 95% CI: 1.28, 1.56). Conclusion: In this population-based cohort study, AKI survivors actively prescribed one or more potentially nephrotoxic medications were at significantly greater risk for de novo or progressive CKD. An opportunity exists to reassess nephrotoxin appropriateness following an AKI episode to improve patient outcomes.

Additional file 1. Fig S1. STROBE flow-diagram. Table S1. Machine learning models. Table S2. Description of existing risk prediction tools. Table S3. Risk prediction models and estimated scores. Table S4. Characteristics of study population by the development and validation cohorts. Panel 1. Methods, additional description. Table S5. STROBE checklist. Table S6. TRIPOD checklist.

Supplemental material, sj-docx-1-cjk-10.1177_20543581221081258 for Development and Feasibility of a Multidisciplinary Approach to AKI Survivorship in Care Transitions: Research Letter by Erin F. Barreto, Heather P. May, Diana J. Schreier, Laurie A. Meade, Brenda K. Anderson, Megan E. Rensing, Kari L. Ruud, Andrea G. Kattah, Andrew D. Rule, Rozalina G. McCoy, Dawn M. Finnie, Joseph R. Herges and Kianoush B. Kashani in Canadian Journal of Kidney Health and Disease

Supplemental Material, sj-pdf-1-jic-10.1177_0885066621998936 for Associations of Vasopressor Requirements With Echocardiographic Parameters After Out-of-Hospital Cardiac Arrest by Meir Tabi, Barry J. Burstein, Nandan S. Anavekar, Kianoush B. Kashani and Jacob C. Jentzer in Journal of Intensive Care Medicine

Additional file 1: Table S1. Subgroup analysis based on in-hospital acute kidney injury status. Table S2. Subgroup analysis based on chronic kidney disease status. Table S3. Subgroup analysis based on end-stage kidney renal disease status.

To evaluate the clinical performance of checklist for early recognition and treatment of acute illness (CERTAIN) on patients in the intensive care unit (ICU).A prospective observational study was performed. 100 patients (age18 years old, the length of ICU stay72 hours) admitted to ICU of the Second People's Hospital of Lu'an from January to July in 2018 were enrolled. By convenience sampling methods, 50 patients admitted to the hospital from January to April in 2018 were selected as the control group. Standard ward inspection was given to the control group by three senior-level and intermediate-level doctors blinded from the research plan; at the end of March 2018, these three doctors were trained with the CERTAIN checklist and certified by the Mayo Clinic distance learning training. Fifty patients enrolled from March to July 2018 received medical rounds using CERTAIN (observation group). The CERTAIN checklist contained 20 items that cover the range of daily critical ward rounds, which need clinicians to quantify each item. The data included the length of ICU stay, central venous catheter (CVC) indwelling time, catheter indwelling time, duration of mechanical ventilation, drug use rate, ICU mortality, and incidence of adverse events were collected and compared between the two groups. The independent factors affecting ICU death were analyzed by log-rank univariate analysis and Cox regression multivariate analysis.Compared with control group, the length of ICU stay (days: 8.68±4.84 vs. 13.64±9.37), catheter indwelling time (days: 8.16±5.29 vs. 13.32±9.31), duration of mechanical ventilation (days: 3.46±4.14 vs. 6.62±9.57) in observation group were significantly decreased, insulin use rate (34.0% vs. 56.0%) and ICU mortality (2.0% vs. 14.0%) were significantly decreased, with statistically significant differences (all P0.05). Besides, the use of CERTAIN can significantly improve the efficiency of the ward inspection. The ward inspection time was shortened from (8.00±0.45) minutes to (5.00±0.33) minutes by using the CERTAIN checklist (t = 9.312, P0.01). Survival analysis showed that CERTAIN application could reduce ICU mortality (χCERTAIN application has a significant effect on critical patients. It is suggested to spread in ICU of China.