WashU Nephrology proudly recognizes Gonzalo Matzumura, MD, Assistant Professor of Medicine and Director of Acute Dialysis Services at Barnes-Jewish Hospital, for his role as co-author and investigator in the landmark LIBERATE‑D (Liberation from Acute Dialysis) trial, published in JAMA on November 7, 2025. The findings were presented simultaneously at ASN Kidney Week 2025 in Houston, as part of the High-Impact Clinical Trials session, with senior author Dr. Chi-yuan Hsu (UCSF) as the lead presenter.
Patients with acute kidney injury (AKI) who require dialysis often face higher risks, greater healthcare use, and reduced quality of life if dialysis continues long-term. The multi-center study tested whether dialysis itself may contribute to kidney injury, proposing that a less intensive approach could speed recovery.
The trial compared a conservative, indication-based dialysis strategy (dialysis only when clinically necessary) versus the standard schedule (three times per week) to determine whether reducing dialysis frequency could improve recovery rates.
The study demonstrated that the conservative strategy in patients with acute kidney injury requiring dialysis led to faster kidney recovery without increased risk of complications compared to the conventional approach. This pivotal work challenges long-standing dialysis practices and points toward a more individualized, patient-centered model of care. While there have been many recent trials about when to start dialysis in AKI, this is the first study to provide guidance about when and how to stop dialysis.
Dr. Matzumura is a graduate of our WashU Nephrology Fellowship Program and joined our faculty in 2021.
“We hope that this serves as a starting point to recognize that care for patients with AKI requiring dialysis is fundamentally different than the care we provide to patients who are on maintenance hemodialysis and that our current practices provide many opportunities for optimization. On a personal level, I was very grateful to participate in a study with renowned experts in the field of AKI, and being able to make a contribution to this study was very rewarding”.
Gonzalo Matzumura
The full article, A Conservative Dialysis Strategy and Kidney Function Recovery in Dialysis-Requiring Acute Kidney Injury: The Liberation From Acute Dialysis (LIBERATE-D) Randomized Clinical Trial, is available in JAMA. Authors: Kathleen D Liu, Edward D Siew, Delphine S Tuot, Anitha Vijayan, Gonzalo Matzumura Umemoto, Bethany C Birkelo, Benjamin J Lee, Y Diana Kwong, Ian E McCoy, Kevin Delucchi, Hanjing Zhuo, Chi-Yuan Hsu.
Follow Dr. Matzumura on X @GMatzumura.
