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Editorial |

Early to Dialyze Healthy and Wise?

Glenn M. Chertow, MD, MPH1; Wolfgang C. Winkelmayer, MD, MPH, ScD2,3
[+] 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.
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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.13 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.35 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

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