What Do Acute Kidney Injury Survivors Want to Know About Their Condition: A Qualitative Study

Rationale & Objective: Acute kidney injury (AKI) in the hospital often occurs with other serious illnesses that take medical priority. Despite a persistent risk of adverse outcomes following hospital discharge, AKI survivors often receive inadequate education about how best to mitigate risks once home. We sought to identify AKI survivors' perceived barriers to shared and informed decision-making regarding their AKI diagnosis and self-management. Study Design: Semistructured phone interviews were used to assess patients' perceived barriers and facilitators to AKI self-management after a hospital-related AKI event. Setting & Participants: AKI survivors discharged from Duke University Hospital in Durham, NC, were recruited for interviews to discuss their AKI experiences. Those who received dialysis for AKI were excluded because their perceptions of AKI care were hypothesized to be much different from those of patients not requiring dialysis. Analytical Approach: Twenty-four interviews were conducted between May and August 2018. Interviews were recorded, transcribed, and analyzed by study team members to identify common themes and discrepancies and reach a final consensus. Results: Five consistent themes emerged after thematic saturation: (1) patients were unaware of their AKI diagnosis; (2) patients lacked information about AKI and how to manage it at home; (3) patients identified a lack of understanding about AKI; (4) patients were concerned about dialysis; and (5) patients wanted to know how to prevent AKI in the future. Limitations: Limitations include recruitment from a single center, all study participants receiving a nephrology consultation, and several patients being unable to participate because of persistent illness following hospitalization. Conclusions: AKI survivors are unaware of their diagnosis, receive suboptimal education while hospitalized, and are not equipped with tools to mitigate risks following discharge. Patient-centered interventions promoting AKI awareness and self management may improve long-term outcomes for high-risk AKI survivors.