Targeting Persistent AKI and Promoting Recovery

This session will discuss post-AKI care, dialysis-dependent acute kidney disease, and strategies to promote kidney recovery after severe AKI.

The case involves an elderly patient with coronary artery disease, diabetes, hypertension, recent NSAID exposure, and rapidly progressive kidney dysfunction due to MPO-ANCA-associated pauci-immune glomerulonephritis. Despite immunosuppressive therapy, plasma exchange, and rituximab induction, the patient remained dialysis-dependent at discharge after a complicated hospital course.

The discussion will focus on kidney recovery assessment, timing of RAS inhibitor initiation or resumption, structured handoff to community dialysis units, individualized dialysis prescription and weaning, and management of dialysis-related electrolyte depletion.