RENAL SYSTEM: Edited by Marlies OstermannIndividualized acute kidney injury after careKoyner, Jay L.a; Haines, Ryan W.b; Bouchard, JoseecAuthor Information aSection of Nephrology, Department of Medicine, University of Chicago, Chicago, Illinois, USA bAdult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, Whitechapel Road, London, UK cDepartment of Medicine, University of Montreal, Montreal, Quebec, Canada Correspondence to Jay L. Koyner, Section of Nephrology, University of Chicago, 5841 South Maryland Ave, Suite S-507, MC 5100 Chicago, IL 60637, USA. E-mail: [email protected] Current Opinion in Critical Care: December 2020 - Volume 26 - Issue 6 - p 581-589 doi: 10.1097/MCC.0000000000000779 Buy Metrics Abstract Purpose of review The aim of this study was to summarize the current evidence around the impact of individualizing patient care following an episode of acute kidney injury (AKI) in the ICU. Recent findings Over the last years, evidence has demonstrated that the follow-up care after episodes of AKI is lacking and standardization of this process is likely needed. Although this is informed largely by large retrospective cohort studies, a few prospective observational trials have been performed. Medication reconciliation and patient/caregiver education are important tenants of follow-up care, regardless of the severity of AKI. There is evidence the initiation and/or reinstitution of renin-angiotensin-aldosterone agents may improve patient's outcomes following AKI, although they may increase the risk for adverse events, especially when reinitiated early. In addition, 3 months after an episode of AKI, serum creatinine and proteinuria evaluation may help identify patients who are likely to develop progressive chronic kidney disease over the ensuing 5 years. Lastly, there are emerging differences between those who do and do not require renal replacement therapy (RRT) for their AKI, which may require more frequent and intense follow-up in those needing RRT. Summary Although large scale evidence-based guidelines are lacking, standardization of post-ICU-AKI is needed. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.