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. Author manuscript; available in PMC: 2021 Dec 1.
Published in final edited form as: Curr Opin Crit Care. 2020 Dec;26(6):581–589. doi: 10.1097/MCC.0000000000000779

Table 2.

Potential interventions after AKI

Interventions Additional information Outcome Level of evidence
Teaching Education around AKI and risk of future HTN, CKD, ESKD, cardiovascular outcomes (HF, MI) and stroke Association between AKI and these outcomes – no data on education and outcomes Meta-analysis [7, 8, 34], retrospective studies [32]
Promote healthy behaviors (diet, exercise, weight) No evidence
Medications Avoidance of NSAID use, medication reconciliation (re-initiation of metformin or sodium-glucose co-transporter 2 inhibitor) No evidence
Blood pressure level Tailor according to patients’ age and comorbidities No evidence
Renin-angiotensin-aldosterone system (RAAS) inhibitors 587 patients - initiation of RAAS inhibitor after renal recovery following cardiac surgery-associated AKI Lower risk of CKD progression (HR 0.46, 95%CI 0.30–0.70) Retrospective analysis of a prospective cohort [25]
1551 patients, RAAS inhibitor after renal recovery Lower risk of mortality at one year (HR 0.48, 95%CI 0.27–0.85) Retrospective cohort [44]
10,242 adults matched for drug use, new use of RAAS inhibitors Not associated with increased AKI requiring hospitalization over 3 years - this latest model accounted for baseline, time-updated, and potential time-dependent confounders Retrospective cohort [62]
46,253 adults matched for drug use

  • New and continued RAAS inhibitors use within 6 months after AKI*

  • Stopping a RAAS inhibitor prescribed before admission

  • Reduced mortality at 2 years (HR 0.85; 95% CI, 0.78–0.93 and HR 0.77; 95% CI, 0.73–0.80, respectively)

  • No association with ESKD (limited data)

  • Increased risk of hospitalization for AKI and/or hyperkalemia (HR 1.28; 95%CI, 1.12–1.46)

  • Increased mortality at 2 years

 Retrospective cohort [43]
Statins AKI developing CKD – missing data on some important covariates Lower risk of mortality after 2 years (HR 0.74; 95%CI 0.69–0.79)
No reduction in cardiovascular events		 Retrospective cohort [45]
No effect on CKD (HR 0.94, 95% CI 0.70–1.25) Retrospective analysis of a prospective cohort [25]
*

Starting a RAAS inhibitor within 90 days compared to after 90 days following discharge was associated with increased mortality