Supporting the Patient through AKI Diagnosis

Over 13 million people worldwide are affected by AKI, which is a sudden and often reversible condition that declines kidney function, increasing morbidity and the risk of CKD.¹ Unfortunately, the incident rate for AKI has increased from 80 per 1000 patient-years in 2007 to 242 per 1000 patient-years in 2022.¹ Various studies provide the clinical perspective of AKI; however, the experiences and aspects of patients affected by this condition are underexplored.

Perspectives and Experiences of Patients with AKI

The systematic review Perspectives and Experiences of Patients with AKI captured ten qualitative studies and ten surveys of 867 participants across six countries affected variously by AKI. Six themes were identified: navigating the unknown, impaired life participation, relationships and well-being, unbearable and unsustainable treatment burden, uncertain if recovery is attainable, less consequential than other health priorities, and empowered in managing own health.²

Each theme provided insight into the patient's viewpoint about their experience being diagnosed with AKI and managing the condition. It is critical that once a patient has been diagnosed with AKI, their healthcare team communicates and works together to ensure that the patient and their family comprehend what AKI is, its risks, its causes, and the comorbidities associated with this condition. The researchers in this study found that some patients were unaware that they had AKI, felt that their condition was minimized, and did not understand their treatment plan or medical terminology; no patient should have experienced this.²

A Patient's Perspective

As a patient with kidney disease and advocate for over 10 years, I can relate to the findings in the Perspectives and Experiences of Patients with AKI systematic review.

I have not always been an informed and engaged patient. It took my dedicated healthcare team working with me, providing educational resources, and individualizing my care to fit my needs and active lifestyle; I experienced firsthand the adverse effects of low health literacy and miscommunication. Participants in this systematic review share how they were tossed about a fragmented system. Some participants expressed that their care plan was ineffective after being released from the intensive care unit; such experiences can be detrimental to patients. It has been studied that AKI can lead to CKD, and CKD can lead to ESKD or even death if the condition is not adequately treated.^2,3

There is Room for Improvement

Each year, approximately 1.7 million individuals worldwide lose the fight against AKI.⁴ We have work to do in the healthcare community! Participants in the systematic review revealed a lack of communication among hospitals, subacute care facilities, and dialysis clinics.²

Participants were also concerned about socially impaired life participation, relationships, and well-being because of the burdens of AKI.² Healthcare professionals must take the time to learn their patients' healthcare goals and resources needed to increase their independence and enhance self-worth, build healthier relationships, and get back to the activities that fulfills them.

The manuscript is resourceful for nephrologists, patients, and healthcare teams of patients with or at risk of AKI. The information can help healthcare professionals better engage, educate, and treat individuals diagnosed with AKI, focusing on preventive measures, collaborative care, and quality improvement. In addition, it is helpful for the healthcare system to include resources and access to patient education workshops led by healthcare professionals and patient advocates, where they can receive information about AKI and learn from each other's experiences.

Furthermore, providing avenues for patients with AKI to participate in peer mentorship programs where more experienced patients can provide support and share beneficial resources that helped them to navigate the challenges of this condition. These practical approaches may establish a network of support that promotes coping mechanisms and overall well-being, leading to better health outcomes. Having a supportive network minimizes mental health challenges common in patients with chronic illnesses.

More Data to Collect

It would have been beneficial to understand whether the participants featured in the systematic review had a support system. A study has shown that patients with support diagnosed with a sudden illness tend to follow their treatment plan, are encouraged, and are motivated to engage in healthier behaviors.⁵

In conclusion, the experiences of patients with AKI disclosed emotional, physical, and social challenges. The findings from the systematic review showed that there is a need for healthcare professionals to work collaboratively, provide patients with access to information, and have open communication, which are all important factors for care management. This approach can empower patients to take charge of their health journey with courage and resilience. Prioritizing the patient's voice can lead to better outcomes and a more patient-centered healthcare experience for all.

Supplementary Material

cjasn-20-315-s001.pdf ^{(1.3MB, pdf)}

Disclosures

Disclosure forms, as provided by each author, are available with the online version of the article at http://links.lww.com/CJN/C157.

Funding

None.

Author Contributions

Writing – original draft: Precious McCowan.

Writing – review & editing: Precious McCowan.