Kidney Week

Abstract: SA-PO545

AKI Awareness Among Hospitalized Survivors of AKI

Session Information

• AKI: Clinical, Outcomes, Trials - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Lunyera, Joseph, Duke University School of Medicine, Durham, North Carolina, United States

Joseph Lunyera,

• Alkon, Aviel N., Duke University School of Medicine, Durham, North Carolina, United States

Aviel N. Alkon,

• Riley, Jennie, Duke University School of Medicine, Durham, North Carolina, United States

Jennie Riley,

• Bowman, Cassandra, Duke University School of Medicine, Durham, North Carolina, United States

Cassandra Bowman,

• Mohottige, Dinushika, Duke University School of Medicine, Durham, North Carolina, United States

Dinushika Mohottige,

• St. Clair Russell, Jennifer, Duke University School of Medicine, Durham, North Carolina, United States

Jennifer St. Clair Russell,

• Diamantidis, Clarissa Jonas, Duke University School of Medicine, Durham, North Carolina, United States

Clarissa Jonas Diamantidis,

Background

Low health literacy (HL) has been linked to poor patient awareness of health conditions, particularly chronic kidney disease (CKD). Little is known about patients’ awareness of AKI, and the role of HL. Using data from the Change AKI study, we examined the association of patient and clinical factors with AKI awareness among hospitalized survivors.

Methods

The Change AKI Study is an ongoing pilot study of an AKI educational intervention for hospitalized survivors of AKI at Duke University Hospital, seen in consultation by an inpatient nephrology service, and enrolled beginning in 2017. All participants completed baseline and 1-month surveys of AKI-related risk factors and awareness. We defined adequate HL at baseline as a Rapid Estimation of Health Literacy Measure (REALM-SF) score ≥7. The primary outcome was baseline AKI awareness, defined as a “yes” response to the question “Before right now, did anyone in the hospital tell you that you had acute kidney injury?” We used multivariate logistic regression to examine the association of HL with baseline AKI awareness, adjusted for patient demographic (age, sex, race, education) and clinical (severity of AKI, need for dialysis, baseline CKD) factors. In a post hoc analysis, we examined the association of discharge-related factors (AKI in discharge summary, instructions, or schedule follow-up care) with AKI awareness at follow-up among those previously unaware at baseline.

Results

Among 61 AKI survivors, 46% were aware of their AKI diagnosis at baseline and 78% had adequate HL. HL was not associated with AKI awareness (odds ratio 2.25, 95% confidence interval 0.61-8.31), even after accounting for demographic or clinical factors. Of 45 participants at follow-up, 20% and 68% had AKI mentioned in their discharge instructions and summaries, respectively. Only 37% had scheduled follow-up care for AKI. Of 30 participants who were unaware at baseline, 43% were aware at follow-up; discharge-related factors were not associated with new AKI awareness.

Conclusion

AKI awareness in hospitalized patients seems unrelated to HL, demographic or clinical factors. Discharge-related educational and follow-up processes are suboptimal and need improvement. Multifactorial interventions targeting AKI awareness need further investigation.

Funding

• NIDDK Support