ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2023 and some content may be unavailable. To unlock all content for 2023, please visit the archives.

Abstract: FR-PO120

Initial Outpatient Dialysis Orders in AKI-D vs. ESKD

Session Information

  • AKI: Outcomes, RRT
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials


  • McCoy, Ian Ellis, University of California San Francisco, San Francisco, California, United States
  • Weinhandl, Eric D., Satellite Healthcare, San Jose, California, United States
  • Hussein, Wael F., Satellite Healthcare, San Jose, California, United States
  • Hsu, Chi-yuan, University of California San Francisco, San Francisco, California, United States

Many hospitalized patients with dialysis-requiring acute kidney (AKI-D) do not fully recover renal function and are discharged to continue hemodialysis at dialysis centers oriented toward treating patients with end-stage kidney disease (ESKD). Little is known about dialysis practice patterns in this population.


We examined initial outpatient dialysis orders for 1,754 AKI-D patients initiating in-center hemodialysis between 7/1/2017 and 6/30/2022 across 67 dialysis centers operated by a medium-sized, not-for-profit dialysis provider. For comparison, 6,197 contemporary patients initiating in-center hemodialysis for ESKD were identified.


Patients initiating outpatient dialysis for AKI-D and ESKD had similar demographics (mean age, 63 in AKI-D vs 64 in ESKD; 60% male in both groups) and body mass indices (mean, 29 kg/m2 in both groups). However, mean pre-dialysis serum creatinine, interdialytic weight gain and pre-dialysis systolic blood pressure, were lower in the AKI-D group (5.3 versus 5.9 mg/dL, 0.9 versus 1.1 kg, and 135 versus 144 mmHg, respectively). Despite these differences, initial dialysis orders were similar. The initially prescribed hemodialysis frequency was 3x/week dialysis for 94% of AKI-D patients and 95% of ESKD patients. Hemodialysis session duration, dialysate sodium, and dialysate temperature were also similar.


Despite dissimilar medical profiles at hemodialysis initiation in the outpatient setting, initial hemodialysis orders for AKI-D and ESKD are largely the same. Greater individualization of dialysis orders may improve patient care.

Initial outpatient dialysis prescriptions in AKI-D and ESKD
 Incident AKI-DIncident ESKD
Sample size (N)1,7546,197
Treatment frequency
3 treatments/week
Session duration
≥4.0 hours
3.5-3.9 hours35%37%
<3.5 hours45%40%
Dialysate sodium
≥140 mEq/L
138-139 mEq/L52%49%
136-137 mEq/L30%30%
<136 mEq/L9%13%
Dialysate potassium
3 mEq/L
2 mEq/L29%37%
Dialysate temperature
Celsius, mean (SD)
36.8 (0.5)36.8 (0.4)


  • NIDDK Support – Satellite Healthcare, Inc, not-for-profit dialysis provider