What Do AKI Survivors Want to Know About Their AKI?: 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 risk 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: Semi-structured 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, as their perceptions of AKI care was hypothesized to be much different than for those 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, discrepancies, and reach 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 received nephrology consultation, and several patients were unable to participate due to persistent illness following hospitalization. Jo urn al Pr e-p roo f