Inclusion Criteria:  AKI-D (acute kidney injury requiring dialysis), attributed at least in part to acute tubular necrosis by clinical nephrology team Age ≥ 18 years Pre-hospitalization eGFR ≥ 15 mL/min/1.73m2 Being discharged to a participating outpatient dialysis unit (within 30 miles of UCSF)  Exclusion Criteria:  Known loop diuretic allergy/intolerance Dialysis duration > 3 months Pregnant Prisoner Unable to consent Clinical team declines to allow approach for study