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Am J Kidney Dis. 2014 Sep;64(3):394-401. doi: 10.1053/j.ajkd.2014.03.018. Epub 2014 May 9.

The daily burden of acute kidney injury: a survey of U.S. nephrologists on World Kidney Day.

Author information

1
Section of Nephrology, University of Chicago, Chicago, IL.
2
Albany Medical College, Albany, NY.
3
Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
4
Department of Medicine, Division of Nephrology, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA.
5
Department of Medicine, University of California San Francisco, San Francisco, CA.
6
Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA.
7
Division of Nephrology, University of Colorado and Denver Veterans Affairs Medical Center, Denver, CO. Electronic address: sarah.faubel@ucdenver.edu.

Abstract

BACKGROUND:

World Kidney Day 2013 focused on raising awareness of the impact and consequences of acute kidney injury (AKI). Although many studies have examined rates of AKI in hospitalized patients, we were interested in the impact of AKI on the workload of nephrologists.

STUDY DESIGN:

Cross-sectional forced-choice internet-based survey.

SETTING & PARTICIPANTS:

598 survey respondents who were US-based nephrologist members of the American Society of Nephrology.

OUTCOMES:

Numbers of inpatients and outpatients seen on World Kidney Day 2013 for the management of AKI or other conditions (and specifically in-hospital renal replacement therapies [RRTs]), based on self-report of number/percentage of patients seen on World Kidney Day and in the prior year.

RESULTS:

Of 598 physician respondents (response rate, 12%), 310 saw patients in the hospital on World Kidney Day. Of 3,285 patients seen by respondents, 1,500 were seen for AKI (46%); 1,233, for end-stage renal disease (37%); and 552, for non-AKI/end-stage renal disease-related problems (17%). Of patients with AKI, 688 (46%) were in the intensive care unit and 415 (28%) received RRT. Intermittent hemodialysis was performed in 315 patients (76%) who received RRT. Delivered dialysis dose was quantified in only 48 (15%) of those receiving intermittent hemodialysis. 260 respondents saw 2,380 patients in the ambulatory setting, of whom 207 (9%) were seen for follow-up of AKI.

LIMITATIONS:

There was a low response rate to the survey. Numbers of patients were self-reported.

CONCLUSIONS:

This is the first physician survey examining the care of patients and impact of AKI on current in-hospital and ambulatory nephrology practices. In our sample, AKI was the most common reason for in-hospital nephrology consultation. Furthermore, our findings point to significant areas in which improvement is needed, including inadequate quantification of dialysis delivered dose. Finally, our survey highlights that AKI is a major public health issue.

KEYWORDS:

Acute kidney injury (AKI); World Kidney Day; dialysis; dialysis dosing; epidemiology; nephrology; public health; survey; workload

PMID:
24815216
DOI:
10.1053/j.ajkd.2014.03.018
[Indexed for MEDLINE]

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