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May 24/31, 2016

Early to Dialyze: Healthy and Wise?

Author Affiliations
  • 1Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Palo Alto, California
  • 2Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas
  • 3Associate Editor, JAMA
JAMA. 2016;315(20):2171-2172. doi:10.1001/jama.2016.6210

Acute kidney injury (AKI) among hospitalized patients is common, consequential, and costly. Annually in the United States, approximately 10% of the estimated 5 million hospitalizations are complicated by AKI, with 0.4% of cases severe enough to require dialysis. Among patients with AKI requiring extracorporeal kidney support (dialysis), in-hospital mortality rates are consistently in excess of 20%, and may exceed 40% when accompanied by nonrenal organ system failure.1-3 Acute kidney injury results in prolonged hospital stay, and is associated with marked increase in hospital costs, with attributable costs estimated to be between $5 billion and $10 billion annually.3-5 Moreover, AKI has been linked with increased longer-term risks of chronic kidney disease (CKD), another condition associated with poor outcomes and high health care resource consumption,6 as well as of higher risks of hypertension.7