More than 20% of patients receiving dialysis at in-center hemodialysis facilities initiate dialysis for acute kidney injury requiring dialysis (AKI-D) rather than end-stage kidney disease (ESKD). The transition from AKI-D to ESKD status is important to reorient clinical efforts from short-term monitoring for recovery to equally important long-term goals of establishing permanent dialysis access and planning for kidney transplant. The timing of this transition is highly variable and determined by the treating nephrologist.