A-E-I-O-U and Sometimes Why—Dialysis in Acute Kidney Injury

Students memorize the indications for dialysis in acute kidney injury (AKI) as the vowels of the alphabet, A-E-I-O-U: acidosis, electrolytes, ingestions, overload, and uremia. In a study published in JAMA, Liu and colleagues ask clinicians to consider the last vowel, sometimes Y (“why”), in their report of the LIBERATE-D trial testing a conservative vs conventional thrice-weekly strategy for dialysis for patients with AKI. A brief historical review of the evolution of strategies for kidney replacement therapy (KRT) will help put LIBERATE-D into context.