Patients with acute kidney injury requiring outpatient dialysis after hospital discharge receive the same care as those with the more common end-stage kidney disease, according to a study led by UC San Francisco.
, some patients on dialysis for acute kidney injury have the potential to recover, the researchers reported in their study in the"For those who have the potential to recover, remaining on dialysis may place them at unnecessary risk for, infection, organ damage and death," said first author Ian E. McCoy, MD, of the UCSF Division of Nephrology.
In the study, researchers tracked data from 1,754 patients with acute kidney injury and 6,197 patients with end-stage kidney disease at outpatient dialysis centers. Although lab tests suggested acute kidney injury patients needed less dialysis, the two groups were treated largely the same. Both were started on thrice-weekly dialysis, and the large majority of patients in both groups were not tested for kidney functioning in the first month of treatment.
"More research is needed on safe weaning strategies," said McCoy."If a patient is weaned off too quickly, they could become short of breath, or they could develop electrolyte abnormalities that can increase the risk of dangerous heart rhythms. "Deprescribing benefits the health care system, but not the dialysis provider, who will have an empty chair that is not easy to fill. At the same time, kidney specialists lose a multidisciplinary support team of nurses, dietitians and social workers when a patient recovers enough to discontinue dialysis.
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