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Many patients with AKI remain unaware of their diagnosis after leaving the hospital
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SAN DIEGO — Among 30 hospitalized survivors of acute kidney injury who were unaware they had the condition at baseline, investigators found that at follow-up 43% were aware they were managed for AKI.
Researchers of the study, presented at ASN Kidney Week 2018, note the findings highlight the need for better discharge-related and follow-up educational interventions for survivors of AKI.
“There had been similar work showing that awareness among patients is low,” study co-author Joseph Lunyera, MBChB, MSc, a postdoctoral associate at Duke University, told Healio Nephrology. “[This] informs us that we need to come up with more innovative ways to let patients retain the important information that they have acute kidney injury, and that there are certain behavioral factors that they should improve.”
In the randomized trial, all patients hospitalized with AKI completed baseline and 1-month surveys regarding AKI-related risk factors and awareness. Lunyera and his colleagues defined adequate health literacy at baseline as a rapid estimation of health literacy measure (REALM-SF) score of at least 7. The primary outcome of the baseline AKI awareness involved patients answering “yes” or “no” to the question, “Before right now, did anyone in the hospital tell you that you had acute kidney injury?”
Among those who were unaware they had AKI at baseline, Lunyera asked again post-discharge and compared those results with patients’ scheduled follow-up care and instructions provided by their doctors.
Of 61 survivors in the study, 46% were aware of their AKI diagnosis at baseline. Researchers found patients’ health literacy score was not associated with AKI awareness, even after considering other factors. According to the study abstract, 20% and 68% of the 45 patients at follow-up “had AKI mentioned in their discharge instructions and summaries, respectively.” In addition, about one-third of these patients scheduled follow-up care for the condition.
Of the 30 patients who had been unaware of their diagnosis at the baseline survey, 43% were aware of their AKI at follow-up.
“There are several reasons which we believe can explain that. One being the fact that these patients had several comorbid conditions,” said Lunyera. “[Then], a nephrology consultant walked in [and] maybe a few minutes later, another team walked in. So, the patient is probably overwhelmed with information on the diagnosis.” – by Kristine Houck, MA, ELS, and Scott Buzby
Reference:
Lunyera J, et al. Abstract SA-PO545. Presented at: ASN Kidney Week; Oct. 23-28, 2018; San Diego.
Disclosure: Lunyera reports no outside funding for this study.