One out of 5 hospitalized patients suffers from acute kidney injury (AKI), a condition that carries markedly elevated risk of mortality, cardiovascular disease, and new/progressive chronic kidney disease (CKD) for survivors.1,2 Postdischarge AKI care represents an opportunity to improve outcomes, as less than 10% of AKI survivors see a nephrologist, and observational studies suggest an association of early nephrology follow-up with improved clinical outcomes.3-5 However, the causal nature of this relationship has not been clarified, nor has the processes of care by which patients may benefit.