Beginning January 1, 2018, dialysis facilities should include acute kidney injury (AKI) patients in National Healthcare Safety Network (NHSN) Dialysis Event Surveillance. Reporting AKI patient data to a new, separate NHSN location will enable CDC to exclude AKI patient data from NHSN Bloodstream Infection (BSI) information shared with CMS for purposes of the ESRD Quality Incentive Program (QIP).
The "Acute Kidney Injury (AKI) Location" should be used to report Dialysis Events, and denominator data, for patients who have acute kidney injury and do not have an end-stage renal disease (ESRD) diagnosis at the time of the Event, or denominator data collection.
The "Acute Kidney Injury Location" will be released as part of the NHSN version 8.8 update. Instructions for using the "Acute Kidney Injury Location" are forthcoming.
Among patients included in the NHSN Dialysis Event Surveillance population, the following criteria should be used to identify patients who have acute kidney injury:
1. No diagnosis of "End Stage Renal Disease" or "ESRD" in the patient medical record, or through the ESRD Medical Evidence Form (Form CMS-2728-U3).
2. Physician-diagnosis of "Acute Kidney Injury" or "AKI" listed in the patient medical record (e.g., nephrologist consult or referral form).
3. The event date, or date of denominator data collection, is not more than 6 months after the date the patient initiated outpatient hemodialysis.