Do you stop hemodialysis and monitor the patient in clinic, or taper dialysis frequency first, when urine output and lab markers suggest kidney recovery in a hemodynamically stable outpatient with dialysis-requiring AKI?

The absence of interdialytic weight gain is generally the first sign of recovery from acute kidney injury (AKI). However, one thing to avoid getting burned on is the patient with severe heart failure who was previously on high-dose diuretics that were stopped when dialysis began. They may have signi...

My tendency would be to stop dialysis altogether and monitor the patient in the clinic. Although, this is often a case-by-case decision.

In this circumstance, I tend to taper the frequency of dialysis over a week or two while monitoring volume status and clearance before stopping dialysis. Logistically, it is easier for me to keep a closer eye on the patient this way rather than scheduling labs and clinic visits into an already overb...