title: Outpatient Dialysis for Patients with AKI: A Policy Approach to Improving Care.
abstract: The rate of AKI requiring dialysis has increased significantly over the past decade in the United States. At the same time, survival from AKI seems to be improving, and thus, more patients with AKI are surviving to discharge while still requiring dialysis. Currently, the options for providing outpatient dialysis in patients with AKI are limited, particularly after a 2012 revised interpretation of the Centers for Medicare and Medicaid Services guidelines, which prohibited Medicare reimbursement for acute dialysis at ESRD facilities. This article provides a historical perspective on outpatient dialysis management of patients with AKI, reviews the current clinical landscape of care for these patients, and highlights key areas of knowledge deficit. Lastly, policy changes that have the opportunity to significantly improve the care of this at-risk population are suggested.
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
authors.forename: Michael
authors.initials: M
authors.lastname: Heung
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material. Sarah.Faubel@ucdenver.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: Faubel
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Watnick
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
authors.forename: Dinna N
authors.initials: DN
authors.lastname: Cruz
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
authors.forename: Jay L
authors.initials: JL
authors.lastname: Koyner
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
authors.forename: Girish
authors.initials: G
authors.lastname: Mour
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
authors.forename: Kathleen D
authors.initials: KD
authors.lastname: Liu
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
authors.forename: Jorge
authors.initials: J
authors.lastname: Cerda
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Okusa
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
authors.forename: Mark
authors.initials: M
authors.lastname: Lukaszewski
authors.affiliation: Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
authors.forename: Anitha
authors.initials: A
authors.lastname: Vijayan
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D000553:Ambulatory Care / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D014487:Centers for Medicare and Medicaid Services, U.S.; D003695:Delivery of Health Care / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006291:Health Policy; D006436:Hemodialysis Units, Hospital / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006801:Humans; D006278:Medicare; D010342:Patient Acceptance of Health Care; D058996:Quality Improvement; D012051:Reimbursement Mechanisms; D006435:Renal Dialysis; D014481:United States
keywords: Centers for Medicare and Medicaid Services; ESRD; acute dialysis; dialysis