Management of Patients With Acute Kidney Injury Undergoing Dialysis After Hospital Discharge

Acute kidney injury is a common diagnosis in hospitalized patients and can range in severity from a minor, reversible rise in creatinine to a more severe kidney injury with resultant complications. In a small but significant percentage of patients with acute kidney injury, renal replacement therapy is required for supportive care. Patients who require renal replacement therapy and survive to hospital discharge face major challenges in recovering from acute illness while adapting to an outpatient dialysis system that was not designed for patients with acute kidney injury. In addition, treating clinicians must navigate complex transitions of care and remain cognizant of signs of renal recovery. This review describes the current evidence in postdischarge acute kidney injury requiring dialysis management. We discuss risk factors for dialysis dependency, markers of kidney recovery, transitions of care, dialysis customization, and quality of life.