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Kidney Week

Abstract: TH-PO024

Patient-Centered AKI: Baseline Characteristics of the Change AKI Study

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Diamantidis, Clarissa Jonas, Duke University School of Medicine, Durham, North Carolina, United States
  • Boulware, L. Ebony, Duke University School of Medicine, Durham, North Carolina, United States
  • Alkon, Aviel N., Duke University, Durham, North Carolina, United States
  • Lunyera, Joseph, Duke University School of Medicine, Durham, North Carolina, United States
  • Riley, Jennie, Duke Un, Durham, North Carolina, United States
  • Bowman, Cassandra, Duke University, Durham, North Carolina, United States
  • St. Clair Russell, Jennifer, Duke University School of Medicine, Durham, North Carolina, United States
Background

Hospital-related AKI carries a threat of poor outcomes that persist after discharge, yet few interventions support patient-centered AKI awareness and self-management beyond the hospital. We describe the study protocol and baseline characteristics of the ongoing Change AKI Study, a pilot study testing the feasibility and acceptance of an mHealth-based educational intervention for AKI survivors.

Methods

Hospitalized AKI survivors at Duke University Hospital seen by the inpatient nephrology service were recruited in 2017-2018. Eligible participants complete baseline surveys including questions regarding their outpatient safety behaviors (e.g. regular use of pain medication such as NSAIDs), perceived AKI knowledge (e.g. “Which of the following statements best describe how much you know about what causes AKI?”), and perceived risk of AKI outcomes (e.g. “How likely do you think it is that you will develop AKI in the future?”). Participants are then randomized to receive an mHealth educational program promoting AKI awareness/self-management, or usual care. Surveys are repeated by phone 1-month after discharge to evaluate changes in behaviors, perceived knowledge, and perceived risk.

Results

To date, 56 participants have completed baseline (28 intervention, 28 control). Half (50%) are female, 57% are aged 45-64 years old, and 42% are Black. Most have completed high school (98%), with a high proportion reporting a history of hypertension (61%) and diabetes (50%). Over half reported regular pain medication prior to hospitalization. Despite receiving a nephrology consult, only 28 (50%) report being aware of their AKI diagnosis – 23% report being told by their primary hospital team. Perceived AKI-related knowledge was variable: what kidneys do (95%), what is AKI (36%) causes of AKI (59%), what to do after AKI (48%). Most (70%) were concerned about recurrent AKI, 52% felt it was likely. While 63% reported confidence in knowing what questions to ask their outpatient provider about AKI, only 50% felt confident they had information to lower their future AKI risk.

Conclusion

AKI awareness, perceived knowledge, and self-management are suboptimal among hospitalized survivors receiving inpatient nephrology care. Interventions designed to improve these patient-centered outcomes may prevent recurrence.