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Abstract: TH-PO052

Improving Patient-Centered Care in Pediatric AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Williams, Anna Elisabeth, Duke University School of Medicine, Durham, North Carolina, United States
  • Gbadegesin, Rasheed A., Duke University School of Medicine, Durham, North Carolina, United States
  • Diamantidis, Clarissa Jonas, Duke University School of Medicine, Durham, North Carolina, United States
Background

Acute kidney injury (AKI) is the sudden loss of kidney function and is a common complication of pediatric hospitalizations, affecting approximately 5-10% of all children admitted to the hospital. Despite a persistent risk of adverse outcomes following hospital discharge, providers infrequently provide education to patients or families on how best to manage AKI once they return home. We sought to identify providers’ perceived challenges to pediatric AKI care in order to inform optimal patient-centered AKI care strategies.

Methods

Physician stakeholders experienced with pediatric AKI were recruited from a single academic center in Durham, North Carolina in June and July 2020 to participate in semi-structured interviews via phone. Interviews assessed perceived barriers and facilitators to post-AKI care for pediatric survivors. The interview guide was developed by the study team using adult learning theory and included open-ended questions. All interviews were recorded and transcribed prior to analysis by the study team for theme identification.

Results

Ten physician interviews—4 of outpatient pediatricians and 6 of pediatric nephrologists—were conducted in summer 2020. Providers relayed several themes related to post-AKI care: patient awareness of AKI diagnosis is low, family concerns (e.g. child’s prognosis, underlying cause of AKI) often arise during AKI discussions, gaps exist in non-subspecialists AKI knowledge, pediatricians rely on subspecialists for co-management of AKI, and pediatric nephrologists readily offer AKI education. Of these themes, low AKI diagnosis awareness and provider knowledge gaps were considered barriers to optimal post-AKI care. Participants also expressed that these barriers were particularly evident when reflecting on AKI care in the neonatal intensive care unit (NICU).

Conclusion

Both pediatric nephrologists and general pediatricians identified patient lack of awareness of diagnosis as a barrier to optimal post-AKI care. Patient-centered educational tools promoting AKI awareness and self-management may improve long-term outcomes for pediatric AKI survivors.

Funding

  • Other NIH Support