Abstract: FR-PO061
Incidence and Clinical Outcomes of Outpatient Hemodialysis for AKI in a Large Dialysis Organization
Session Information
- AKI: Clinical Outcomes, Trials
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Weinhandl, Eric D., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Dalrymple, Lorien S., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Sun, Yuping, Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Ofsthun, Norma J., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background
Little is known about patients undergoing outpatient hemodialysis (OP HD) for acute kidney injury requiring dialysis (AKI-D) in the US. We examined the incidence and clinical outcomes of such patients in a large dialysis organization.
Methods
We examined patients initiating OP HD for AKI-D in a Fresenius Kidney Care (FKC) dialysis facility between May 1, 2017, and December 31, 2018; we excluded those discharged from FKC facilities within 7 days of initiation of OP HD. Patients were followed from initiation until the earliest of recovery of kidney function, transition to end-stage kidney disease (ESKD), death, or loss to follow-up (typically, transfer to another dialysis provider), with end of follow-up on March 31, 2019.
Results
The cohort comprised 15,606 patients with AKI-D; monthly counts increased from approximately 650 during mid-2017 to 850 during late 2018. Mean age was 63.6 ± 14.6 years and 41% were female. The vast majority (97%) were prescribed thrice-weekly HD, with mean session duration of 223 ± 26 minutes.
During follow-up, 6028 (39%) recovered kidney function, 7104 (46%) transitioned to ESKD, and 1550 (10%) died. Cumulative incidence of these events is displayed. At 1 month after initiation of OP HD for AKI-D, 18% had recovered function, 9% had transitioned to ESKD, and 5% had died; at 3 months, percentages were 38%, 44%, and 10%.
In 14,682 patients who reached any endpoint, mean (median) days between first and last OP HD sessions was 50 (45).
Conclusion
During 2017 and 2018, an increasing number of patients underwent OP HD for AKI-D in one large dialysis organization. Within 3 months after initiation of OP HD, approximately 40% of patients recovered enough kidney function to discontinue dialysis and 45% transitioned to ESKD.