Kidney Week

Abstract: FR-PO0427

Patient-Reported Outcomes by Dialysis Weaning Strategy in Dialysis-Requiring AKI

Session Information

• AKI: Biomarkers, Diagnostics, and Risk Prediction
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Kwong, Yuenting Diana, UCSF Health, San Francisco, California, United States

Yuenting Diana Kwong, MD, MAS, FASN

• Hsu, Chi-yuan, UCSF Health, San Francisco, California, United States

Chi-yuan Hsu, MD, MSc, FASN

• Siew, Edward D., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Edward D. Siew, MD, MS, MSc

• Tuot, Delphine S., Zuckerberg San Francisco General, San Francisco, California, United States

Delphine S. Tuot, MD

• Vijayan, Anitha, Intermountain Health, Salt Lake City, Utah, United States

Anitha Vijayan, MD, FASN

• Matzumura Umemoto, Gonzalo, Washington University in St Louis, St. Louis, Missouri, United States

Gonzalo Matzumura Umemoto, MD

• McCoy, Ian Ellis, UCSF Health, San Francisco, California, United States

Ian Ellis McCoy, MD, MS, FASN

• Birkelo, Bethany, University of Minnesota Medical School, Minneapolis, Minnesota, United States

Bethany Birkelo, DO, MSc

• Lee, Benjamin J., Houston Methodist, Houston, Texas, United States

Benjamin J. Lee, MD, FASN

• Zhuo, Hanjing, UCSF Health, San Francisco, California, United States

Hanjing Zhuo, MD, MPH

• Miaskowski, Christine, UCSF Health, San Francisco, California, United States

Christine Miaskowski, PhD, RN

• Liu, Kathleen D., UCSF Health, San Francisco, California, United States

Kathleen D. Liu, MD, PhD, FASN

Background

While a conservative dialysis strategy may promote renal recovery, reduced dialysis may worsen quality of life (QOL) or increase symptom burden. Differences in patient reported outcomes (PROs) were evaluated between Liberation from Acute Dialysis (LIBERATE-D) trial (NCT04218370) participants with dialysis requiring acute kidney injury (AKI-D) who were randomized to dialysis performed only for specific indications (conservative arm) or thrice weekly dialysis until recovery by urine output or creatinine clearance criteria (standard arm).

Methods

At enrollment, study day 7, 14, 28, and 90, participants were asked to rate their QOL on a 1 (very poor) to 7 (excellent) scale and to complete the Dialysis Symptoms Index (DSI) survey. Generalized estimating equations were applied to evaluate the associations between the study intervention and PRO trajectories.

Results

Across 220 participants, survey completion declined from 58% at enrollment to 39% at day 90. Altered mental status (n=52) was the primary reason for surveys completed at enrollment. Among responders, QOL improved and symptom burden decreased over 90 days. No differences were found in the trajectories for QOL (Figure 1), total symptom burden (Figure 2), or specific symptom occurrence between dialysis strategies (p-interaction>0.05).

Conclusion

PROs improved over 90 days following AKI-D. No differences in PROs were found between dialysis strategies, suggesting that a conservative dialysis strategy may not decrease patients' QOL or increase symptom burden while optimizing for renal recovery.

Acknowledgment

We thank all patients and families who participated in the trial and the LIBERATE-D study coordinators who assisted with the collection of patient reported outcomes.

Figure 1

Figure 2

Funding

• NIDDK Support