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Kidney Week

Abstract: SA-PO161

Kidney Recovery in Patients Discharged with AKI Requiring Hemodialysis to Outpatient Centers

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Jordan, Melissa Rae, University of Kentucky, Lexington, Kentucky, United States
  • Ortiz-Soriano, Victor M., University of Kentucky, Lexington, Kentucky, United States
  • Chism, Lauren, University of Kentucky, Lexington, Kentucky, United States
  • Pruitt, Aaron, University of Kentucky, Lexington, Kentucky, United States
  • Sawaya, B. Peter Emile, University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Malluche, Hartmut H., University of Kentucky, Lexington, Kentucky, United States
  • Neyra, Javier A., University of Kentucky Medical Center, Lexington, Kentucky, United States
Background

As of January 2017, patients with acute kidney injury requiring dialysis (AKI-D) can be discharged to outpatient centers for continued hemodialysis (HD) support. We aimed to examine kidney recovery and time-to-recovery in these patients.

Methods

Single-center, prospective cohort study of 118 adult patients who were admitted to the University of Kentucky Hospital (7/2017-2/2019), suffered from AKI-D and were discharged to non-academic affiliated outpatient HD centers. Kidney recovery was defined as the patient being alive and no longer requiring HD and was assessed at 30-day intervals up to 90 days post discharge.

Results

Of the 118 patients diagnosed with AKI-D during the index hospitalization, 15 patients were declared ESKD prior to discharge. We excluded patients that were prisoners (n=2) or were lost to follow-up (n=19). There were 5 patients that were misclassified as ESKD at their HD center despite being discharged as AKI-D. Among the remaining 77 patients, mean (SD) age was 54.4 (16.0) years; 61% were male and 88.3% white. Overall 29 (37.6%) patients recovered kidney function, about two-thirds of them within the first 30 days of hospital discharge [Figure].

Conclusion

At least 1 out of 3 AKI-D patients discharged to outpatient HD units with continued HD need recovered kidney function within 90 days of hospital discharge. The majority of patients recovered kidney function within 30 days of discharge, illustrating a critical window for surveillance and intervention. Future studies should focus on identifying best practices to promote recovery in this susceptible population.

Kidney recovery assessment in patients discharged with AKI requiring hemodialysis to outpatient centers