Initial Management and Potential Opportunities to Deprescribe Dialysis among Patients with AKI-D Patients after Hospital Discharge

Significance StatementDialysis-requiring AKI (AKI-D) now accounts for more than 15% of outpatient hemodialysis initiations; over 30% of these patients with AKI-D may have potential to recover. However, little is known about strategies currently used to treat outpatient AKI-D and screen for recovery. In this study of 1754 patients with AKI-D, we found that (1) the initial dialysis orders were similar to those of patients with contemporary incident ESKD, despite different treatment goals; (2) timed urine collections were completed in only a minority of patients; and (3) most patients with AKI-D who recovered discontinued dialysis without ever having been weaned from their initial dialysis prescription, suggesting there may be substantial opportunity to wean dialysis sooner.

Automated summary

This study highlights the importance of treatment strategies and recovery screening for outpatient AKI-D. The results show that current treatment strategies still have some issues, such as inadequate initial dialysis orders and low completion rate of timed urine collections. However, the study also reveals the opportunity to potentially reduce dialysis frequency sooner.