Identification of barriers to patient education and awareness following dialysis-requiring AKI.

BACKGROUND

Survivors of acute kidney injury (AKI) requiring dialysis remain at high risk for adverse outcomes, including both recurrent AKI and mortality. Patient awareness and education are prerequisites to pursuing kidney-protective behaviors as a potential approach to improve post-AKI outcomes. The goals of this study were to assess post-AKI awareness and follow-up among patients who suffered AKI-D, and to identify barriers and opportunities to improve post-AKI patient education.

METHODS

We conducted a single-center, retrospective study of patients hospitalized in 2021 who survived AKI-D and no longer required dialysis upon discharge. Patients with end-stage kidney disease (ESKD), kidney transplant recipients, and hospice-bound patients were excluded. Charts were reviewed to identify documentation of AKI patient education and follow-up instructions. Patient AKI knowledge was assessed using a survey administered via text or phone call.

RESULTS

A total of 91 eligible patients were identified. At one year, post-discharge mortality was 11%, and 34% of survivors had received nephrology follow-up. A diagnosis of AKI was documented on the patient after-visit summary for 54% of patients. Among surveyed patients, 20% were unaware of their AKI. No patients described themselves as very knowledgeable about their AKI or current kidney health. Patient-reported barriers to nephrology follow-up included lack of knowledge regarding how to set up an appointment and competing priorities including other healthcare appointments and non-healthcare obligations.

CONCLUSIONS

One in five AKI-D patients were unaware of their AKI diagnosis. We identified several potential opportunities to improve post-AKI education, including more consistent education and follow-up processes.