Hospital Medicine Partnership

Your Nephrology Backup

Managing inpatients with AKI shouldn't mean waiting hours for a nephrology consult. KidneyCare provides rapid response, clear recommendations, and shared care that makes your job easier—not harder.

What We Bring to Your Team

< 4 hrs
Consult response time
24/7
Attending availability
Direct
MD-to-MD communication
Clear
Recommendations, not hedging

The AKI Challenge for Hospitalists

You see the creatinine rising. You know nephrology input would help. But the barriers are real.

Consult Delays

Hours or days waiting for nephrology to see your patient. Meanwhile, creatinine keeps climbing.

Vague Recommendations

'Continue to monitor' doesn't help you decide when to initiate dialysis or adjust meds.

Communication Gaps

Notes that don't answer your actual question. Phone tag with rotating fellows.

After-Hours Uncertainty

Nights and weekends mean covering without nephrology backup when AKI worsens.

Dialysis Logistics

When your patient finally needs dialysis, who coordinates equipment, access, nursing?

Discharge Complications

AKI patients with unclear follow-up plans. Readmissions that could have been prevented.

How We Support Your Practice

Nephrology partnership that actually makes your workflow better

Rapid Response

New consults seen within 2-4 hours during business hours, 4 hours after hours. Urgent cases (hyperkalemia, pulmonary edema) prioritized immediately.

Direct Communication

When you call, you reach an attending nephrologist. No phone tag, no message relay through nurses. Real-time discussion of your patient.

Actionable Recommendations

Clear guidance: 'Start dialysis today' or 'Hold, observe, here are the triggers.' We answer your actual question.

True 24/7 Coverage

Attending-level coverage nights, weekends, and holidays. Your patient's AKI doesn't wait for Monday morning.

Complete Dialysis Services

When dialysis is needed, we handle everything: equipment, nursing, access evaluation. You focus on the rest of the patient.

Shared Care Model

We're consultants, not competitors. You remain the primary team. We support, not supplant.

What We Handle for You

You manage the whole patient. We manage the kidneys. Here's where we add value:

AKI evaluation and staging (KDIGO criteria)
Dialysis initiation decisions and timing
CRRT for ICU patients on pressors
Electrolyte management (hyperkalemia, acidosis)
Volume assessment and fluid recommendations
Nephrotoxin identification and alternatives
Contrast-induced nephropathy prevention
CKD management and optimization
Dialysis access evaluation and placement coordination
Discharge planning for dialysis patients

When to Call Us

Rising Creatinine
Cr increase >0.3 or 1.5x baseline within 48 hours
Hyperkalemia
K+ >6.0 or symptomatic with ECG changes
Volume Overload
Diuretic-refractory pulmonary edema
Severe Acidosis
pH <7.2 not responding to treatment
Uremic Symptoms
Encephalopathy, pericarditis, bleeding

Communication That Works

We know you're busy. Our communication style respects your time while keeping you informed:

  • One-page notes with recommendations up front, not buried
  • Direct phone updates for significant changes
  • Clear dialysis triggers documented so you can anticipate
  • Proactive communication when creatinine trends worsen
  • Availability for quick questions via secure text
  • Coordination with discharge planning from day one

Our Note Format

Assessment

AKI Stage 2, likely ATN from sepsis. No indication for urgent dialysis currently.

Recommendations

  • 1. Avoid nephrotoxins (hold vancomycin, renally dose others)
  • 2. Target MAP >65 for renal perfusion
  • 3. Dialysis triggers: K+ >6.5, pH <7.2, severe volume overload

Follow-up Plan

Will round daily. Call if K+ >6 or urine output drops.

Frequently Asked Questions

How quickly can you see a new consult?

During business hours, we aim to see new consults within 2-4 hours. After hours and weekends, our attending is available within 4 hours. For emergent situations (severe hyperkalemia, pulmonary edema), we prioritize immediate response and can often be at bedside within an hour.

Do you handle the dialysis logistics, or do we need to coordinate that?

We handle everything. When dialysis is indicated, we arrange the equipment, dialysis nursing, and treatment schedule. We coordinate with vascular surgery or IR if access is needed. You don't need to make separate arrangements.

What if I just have a quick question and don't need a full consult?

Call us anyway. We're happy to provide quick guidance over the phone for straightforward questions. If it turns out a formal consult is needed, we'll let you know. We'd rather you call early than wait until things are more complicated.

How do you handle ICU patients who need CRRT?

CRRT is one of our specialties. We provide the equipment, trained nursing staff, and 24/7 nephrologist oversight. We coordinate daily with the ICU team on goals of care, fluid balance targets, and antibiotic dosing adjustments.

What about patients who will need outpatient dialysis after discharge?

We help coordinate the transition. If the patient needs chronic dialysis, we can facilitate outpatient appointments and, if appropriate, placement at one of our SNF partners for patients going to skilled nursing with dialysis needs.

Ready for Better Nephrology Support?

Let's discuss how KidneyCare can support your hospitalist practice. Rapid response, clear communication, shared care.