How long is the average length of dialysis treatment for a person with AKI?
There is no standard protocol in terms of the total duration of acute dialysis treatments for AKI, but generally it is on the order of days to weeks. Nephrologists pay close attention to each individual patient’s urine output and laboratory data to assess if that person’s kidneys may be recovering and he/she may be taken off temporary/ acute dialysis.
Many AKI patients who required dialysis do recover kidney function completely and do not need long-term dialysis (with “long-term” generally meaning until the end of the patient’s life, unless he or she receives a renal transplant). Others recover enough kidney function to come off dialysis but are left with kidney function worse than before the AKI episode. The rest either die or remain on dialysis permanently.
Dr. Chi-yuan Hsu’s prior study showed that fewer than 10% of individuals without any pre-existing kidney disease who suffered dialysis-requiring AKI remained on dialysis long-term. That percentage increases drastically for those with pre-existing kidney disease: About half who suffered dialysis-requiring AKI will remain on dialysis long-term.
Which patient populations are most at risk for dialysis-requiring AKI?
Patients with pre-existing chronic kidney disease are the ones most at risk for dialysis-requiring AKI. Other at-risk populations include the elderly.
What steps can nephrologists or other health-care professionals take to help reduce a patient’s risk of dialysis-requiring AKI?
For clinicians, we hope that just being more aware of how common dialysis-requiring AKI is will help them take initial steps to help reduce a patient’s risk. First, clinicians need to identify the patients at the highest risk of AKI, such as those with underlying chronic kidney disease and advanced age, so that they may more carefully reduce those patients’ exposure to medications and procedures that may be toxic to the kidneys, as well as more judiciously manage their fluid status (since dehydration is a common precipitant for AKI).
Clinicians should also discuss with their at-risk patients the risks and benefits of undergoing procedures or interventions that may trigger AKI.