Conservative strategy linked to higher rates of recovery and earlier recovery of kidney function in unadjusted analysis
By Elana Gotkine HealthDay Reporter
TUESDAY, Nov. 18, 2025 (HealthDay News) — For adult patients with dialysis-requiring acute kidney injury, a conservative dialysis strategy is associated with higher rates of recovery of kidney function in an unadjusted analysis, according to a study published online Nov. 7 in the Journal of the American Medical Association.
Kathleen D. Liu, M.D., Ph.D., from the University of California, San Francisco, and colleagues examined the impact of a conservative dialysis strategy on recovery of kidney function in a randomized superiority trial involving participants with dialysis-requiring acute kidney injury who had already initiated kidney replacement therapy and were hemodynamically stable. A total of 220 adult patients received the conservative dialysis strategy of dialysis only when specific metabolic or clinical indications were met or the conventional dialysis strategy of dialysis three times per week until urine output or creatinine clearance criteria were met.
The researchers found that 64 and 50 percent of participants in the conservative and conventional dialysis groups, respectively, achieved kidney function recovery at hospital discharge (unadjusted odds ratio, 1.76; 95 percent confidence interval, 1.02 to 3.03; P = 0.04; odds ratio after prespecified adjustment, 1.56; 95 percent confidence interval, 0.86 to 2.84; P = 0.15). In the conservative dialysis group, participants received fewer dialysis sessions per week (median, 1.8; difference, −1.4) and recovered earlier (21 versus five consecutive dialysis-free days to day 28). The conservative dialysis group had dialysis-associated hypotension less often (69 versus 97 events).
“Generally, dialysis centers do not have the infrastructure to support our weaning intervention,” Liu said in a statement. “This would include daily assessments of patients’ labs and vital signs.”
Several authors disclosed ties to the biopharmaceutical and medical technology industries.
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