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https://www.readbyqxmd.com/read/28402560/acute-kidney-injury-electronic-alerts-in-primary-care-findings-from-a-large-population-cohort
#1
Jennifer Holmes, Nicholas Allen, Gethin Roberts, John Geen, John D Williams, Aled O Phillips
Background: Electronic reporting of AKI has been used to aid early AKI recognition although its relevance to CA-AKI and primary care has not been described. Aims: We described the characteristics and clinical outcomes of patients with CA-AKI, and AKI identified in primary care (PC-AKI) through AKI e-Alerts. Design: A prospective national cohort study was undertaken to collect data on all e-alerts representing adult CA-AKI. Method: The study utilised the biochemistry based AKI electronic (e)-alert system that is established across the Welsh National Health Service...
April 11, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28343224/the-evidence-of-acute-kidney-injury-in-the-community-and-for-primary-care-interventions
#2
Lauren Emmett, James Tollitt, Sheila McCorkindale, Smeeta Sinha, Dimitrios Poulikakos
BACKGROUND: Almost two-thirds of patients with acute kidney injury (AKI) damage their kidneys whilst in the community. This paper aims to review existing data on incidence, mortality, and morbidity of AKI within the community and explore the evidence base for primary care strategies aimed at reducing incidence and improving early detection and management of AKI. METHODS: A literature search was carried out using PubMed; key words including AKI, primary care, community acquired, and electronic alerts (e-alerts) were used to capture relevant data...
March 25, 2017: Nephron
https://www.readbyqxmd.com/read/28282296/herbal-and-dietary-supplements-related-to-diarrhea-and-acute-kidney-injury-a-case-report
#3
Suphamat Wanitsriphinyo, Mayuree Tangkiatkumjai
Background There is very little evidence relating to the association of herbal medicine with diarrhea and the development of acute kidney injury (AKI). This study reports a case of diarrhea-induced AKI, possibly related to an individual ingesting copious amounts of homemade mixed fruit and herb puree. Case presentation A 45-year-old Thai man with diabetes had diarrhea for 2 days, as a result of taking high amounts of a puree made up of eight mixed fruits and herbs over a 3-day period. He developed dehydration and stage 2 AKI, with a doubling of his serum creatinine...
March 1, 2017: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/28268210/leveraging-big-data-and-electronic-health-records-to-enhance-novel-approaches-to-acute-kidney-injury-research-and-care
#4
Scott M Sutherland, Stuart L Goldstein, Sean M Bagshaw
While acute kidney injury (AKI) has been poorly defined historically, a decade of effort has culminated in a standardized, consensus definition. In parallel, electronic health records (EHRs) have been adopted with greater regularity, clinical informatics approaches have been refined, and the field of EHR-enabled care improvement and research has burgeoned. Although both fields have matured in isolation, uniting the 2 has the capacity to redefine AKI-related care and research. This article describes how the application of a consistent AKI definition to the EHR dataset can accurately and rapidly diagnose and identify AKI events...
2017: Blood Purification
https://www.readbyqxmd.com/read/28143633/electronic-alerts-for-acute-kidney-injury
#5
Michael Haase, Andreas Kribben, Walter Zidek, Jürgen Floege, Christian Albert, Berend Isermann, Bernt-Peter Robra, Anja Haase-Fielitz
BACKGROUND: Acute kidney injury (AKI) often takes a complicated course if diagnosed late and undertreated. Electronic alerts that provide an early warning of AKI are intended to support treating physicians in making the diagnosis of AKI and treating it appropriately. The available evidence on the effects of such alert systems is inconsistent. METHODS: We employed the PRISMA recommendations for systematic literature reviews to identify relevant articles in the PubMed, Scopus, and Web of Science databases...
January 9, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28122032/approaches-to-predicting-outcomes-in-patients-with-acute-kidney-injury
#6
Danielle Saly, Alina Yang, Corey Triebwasser, Janice Oh, Qisi Sun, Jeffrey Testani, Chirag R Parikh, Joshua Bia, Aditya Biswas, Chess Stetson, Kris Chaisanguanthum, F Perry Wilson
Despite recognition that Acute Kidney Injury (AKI) leads to substantial increases in morbidity, mortality, and length of stay, accurate prognostication of these clinical events remains difficult. It remains unclear which approaches to variable selection and model building are most robust. We used data from a randomized trial of AKI alerting to develop time-updated prognostic models using stepwise regression compared to more advanced variable selection techniques. We randomly split data into training and validation cohorts...
2017: PloS One
https://www.readbyqxmd.com/read/28088774/association-between-e-alert-implementation-for-detection-of-acute-kidney-injury-and-outcomes-a-systematic-review
#7
Philippe Lachance, Pierre-Marc Villeneuve, Oleksa G Rewa, Francis P Wilson, Nicholas M Selby, Robin M Featherstone, Sean M Bagshaw
Background.: Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain. Methods.: We performed a systematic review. Electronic databases and grey literature were searched for original studies published between 1990 and 2016. Randomized, quasi-randomized, observational and before-and-after studies that included hospitalized patients, implemented e-alerts for AKI and described their impact on one of care processes, patient-centred outcomes or resource utilization measures were included...
February 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28074790/incidence-and-progression-of-cardiac-surgery-associated-acute-kidney-injury-and-its-relationship-with-bypass-and-cross-clamp-time
#8
Habib Md Reazaul Karim, Mohd Yunus, Manuj Kumar Saikia, Jyoti Prasad Kalita, Mrinal Mandal
INTRODUCTION: Cardiac surgery-associated kidney injury (CSA-AKI) is common but relatively less is known about its progression. The present study is aimed at evaluating the incidence and course of CSA-AKI and its relationship with the different durations of cardiopulmonary bypass (CPB) and cross clamp times. MATERIALS AND METHODS: Occurrences of CSA-AKI are evaluated as per the Akin Kidney Injury Network (AKIN) criteria over the course of 5 postoperative day (POD) in 100 patients...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28061831/acute-kidney-injury-as-an-independent-risk-factor-for-unplanned-90-day-hospital-readmissions
#9
Simon Sawhney, Angharad Marks, Nick Fluck, David J McLernon, Gordon J Prescott, Corri Black
BACKGROUND: Reducing readmissions is an international priority in healthcare. Acute kidney injury (AKI) is common, serious and also a global concern. This analysis evaluates AKI as a candidate risk factor for unplanned readmissions and determines the reasons for readmissions. METHODS: GLOMMS-II is a large population cohort from one health authority in Scotland, combining hospital episode data and complete serial biochemistry results through data-linkage. 16453 people (2623 with AKI and 13830 without AKI) from GLOMMS-II who survived an index hospital admission in 2003 were used to identify the causes of and predict readmissions...
January 6, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28030868/implementation-of-an-automated-primary-care-acute-kidney-injury-warning-system-a-quantitative-and-qualitative-review-of-2-years-of-experience
#10
REVIEW
Omid Sadeghi Alavijeh, Jas Bansal, Katie Hadfield, Christopher Laing, Anne Dawnay
BACKGROUND: Acute kidney injury (AKI) is often detected late, leading to worse clinical outcomes. In 2012, we pioneered an AKI-alerting system for primary care clinicians (PCCs). We retrospectively analysed the alerts and evaluated PCC satisfaction to assess the feasibility of the system. METHODS: The study used a 2-pronged approach. AKI alerts, generated by an algorithm designed by University College London Hospital biochemistry department between June 2012 and June 2014, were analysed to reveal the demographics and outcomes of each patient generating an alert...
2017: Nephron
https://www.readbyqxmd.com/read/28030861/the-use-of-automated-electronic-alerts-in-studying-short-term-outcomes-associated-with-community-acquired-acute-kidney-injury
#11
Adil M Hazara, Musab Elgaali, Sarah Naudeer, Stephen Holding, Sunil Bhandari
BACKGROUND/AIMS: The use of electronic alerts (e-alerts) may increase the detection rate of acute kidney injury (AKI) since they are sensitive to small changes in serum creatinine. Our aim was to follow-up a cohort of patients presenting to hospital from the community with AKI (community-acquired AKI [c-AKI]), detected through the use of e-alerts, and describe their short-term outcomes regardless of whether they were subsequently admitted to hospital. METHODS: Blood samples for all hospital attenders from the community either to the Accidents and Emergency department or one of the acute care areas of the hospital during a 6-month period (November 1, 2013-April 30, 2014) were screened for presence of c-AKI using a locally developed e-alerts system based on Kidney Disease: Improving Global Outcomes criteria...
2017: Nephron
https://www.readbyqxmd.com/read/27951559/automated-electronic-alert-systems-for-acute-kidney-injury-current-status-and-future-perspectives
#12
Eiichiro Uchino, Naoya Kondo, Takeshi Matsubara, Motoko Yanagita
BACKGROUND: Acute kidney injury (AKI) is a common and serious condition, but the process of care for patients with AKI is currently suboptimal. Automated AKI electronic (e)-alert systems are expected to improve the process of care and patient outcomes. SUMMARY: There have been several reports on the implementation of e-alert systems, which have the potential to improve patient outcomes, but evidence of their effectiveness has not been established. There are some challenges to the development of better e-alert systems...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27793961/acute-kidney-injury-in-the-era-of-the-aki-e-alert
#13
Jennifer Holmes, Timothy Rainer, John Geen, Gethin Roberts, Kate May, Nick Wilson, John D Williams, Aled O Phillips
BACKGROUND AND OBJECTIVES: Our aim was to use a national electronic AKI alert to define the incidence and outcome of all episodes of community- and hospital-acquired adult AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A prospective national cohort study was undertaken in a population of 3.06 million. Data were collected between March of 2015 and August of 2015. All patients with adult (≥18 years of age) AKI were identified to define the incidence and outcome of all episodes of community- and hospital-acquired AKI in adults...
December 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27784284/case-report-severe-bradycardia-a-reversible-cause-of-cardio-renal-cerebral-syndrome
#14
Mabel Aoun, Randa Tabbah
BACKGROUND: Cardio-Renal Syndromes were first classified in 2008 and divided into five subtypes. The type 1 Cardio-Renal Syndrome (CRS) is characterized by acute decompensation of heart failure leading to acute kidney injury (AKI). Bradyarrhythmia was not mentioned in the classification as a cause for low cardiac output (CO) in type 1 CRS. Besides, CRS was not previously associated with central nervous system (CNS) injury despite the fact that cardiac, renal and neurological diseases can coexist...
October 26, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27736815/acute-kidney-injury-electronic-alert-for-nephrologist-reactive-versus-proactive
#15
COMMENT
Kianoush Kashani, Claudio Ronco
Acute kidney injury (AKI) is a common complication of acute illnesses with significant impact on the mortality and morbidity. Early recognition of AKI allows clinicians to provide prophylactic interventions and to improve the outcomes of this deadly syndrome. Growing utilization and capabilities of electronic health records allow AKI risk stratification and early recognition with a potential effect on the processes of care and outcomes. We evaluate the current level of evidence on the impact of the AKI e-alert on the processes of care and outcomes...
2016: Blood Purification
https://www.readbyqxmd.com/read/27543592/acute-kidney-outreach-to-reduce-deterioration-and-death-akordd-trial-the-protocol-for-a-large-pilot-study
#16
Tarek Samy Abdelaziz, Antje Lindenmeyer, Jyoti Baharani, Hema Mistry, Alice Sitch, R Mark Temple, Gavin Perkins, Mark Thomas
INTRODUCTION: Acute kidney injury (AKI) contributes to morbidity and mortality, and its care is often suboptimal and/or delayed. The Acute Kidney Outreach to Reduce Deterioration and Death (AKORDD) study is a large pilot testing provision of early specialist advice, to improve outcomes for patients with AKI. METHODS AND ANALYSIS: This before and after study will test an Outreach service for adult patients with AKI, identified using the national algorithm. During the 2-month before phase, AKI outcomes (30-day mortality, need for dialysis or AKI stage deterioration) will be observed in the intervention and control hospitals and their respective community areas; no interventions will be delivered...
August 19, 2016: BMJ Open
https://www.readbyqxmd.com/read/27478598/provider-acceptance-of-an-automated-electronic-alert-for-acute-kidney-injury
#17
Janice Oh, Joshua R Bia, Muhamad Ubaid-Ullah, Jeffrey M Testani, Francis Perry Wilson
BACKGROUND: Clinical decision support systems, including electronic alerts, ideally provide immediate and relevant patient-specific information to improve clinical decision-making. Despite the growing capabilities of such alerts in conjunction with an expanding electronic medical record, there is a paucity of information regarding their perceived usefulness. We surveyed healthcare providers' opinions concerning the practicality and efficacy of a specific text-based automated electronic alert for acute kidney injury (AKI) in a single hospital during a randomized trial of AKI alerts...
August 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27376867/design-and-rationale-of-tackling-acute-kidney-injury-a-multicentre-quality-improvement-study
#18
RANDOMIZED CONTROLLED TRIAL
Nicholas M Selby, Anna Casula, Laura Lamming, Mohammed Mohammed, Fergus Caskey
Acute kidney injury (AKI) is common and associated with extremely poor outcomes. While strategies to tackle deficiencies in basic care delivery are advocated, robust testing of their effectiveness is also needed. The Tackling AKI study was designed to test whether a complex intervention (consisting of an e-alert, care bundle and education programme) can be successfully implemented across a range of UK hospitals, and whether this will deliver improved patient outcomes. This multicentre, pragmatic clinical trial will employ a cluster randomised stepped wedge design to study this in all adult patients who sustain AKI in the 5 participating hospitals over a 2-year period...
2016: Nephron
https://www.readbyqxmd.com/read/27231884/development-and-application-of-an-alert-system-to-detect-cases-of-food-poisoning-in-japan
#19
Akie Maeyashiki, Manabu Akahane, Hiroaki Sugiura, Yasushi Ohkusa, Nobuhiko Okabe, Tomoaki Imamura
Recent public health concerns regarding commercial food products have increased the need to develop an automated method to detect food product-related health events. We developed and verified a method for the early detection of potentially harmful events caused by commercial food products. We collected data from daily internet-based questionnaires examining the presence or absence of symptoms and information about food purchased by the respondents. Using these data, we developed a method to detect possible health concerns regarding commercialized food products...
2016: PloS One
https://www.readbyqxmd.com/read/27190340/kdigo-based-acute-kidney-injury-criteria-operate-differently-in-hospitals-and-the-community-findings-from-a-large-population-cohort
#20
Simon Sawhney, Nick Fluck, Simon D Fraser, Angharad Marks, Gordon J Prescott, Paul J Roderick, Corri Black
BACKGROUND: Early recognition of acute kidney injury (AKI) is important. It frequently develops first in the community. KDIGO-based AKI e-alert criteria may help clinicians recognize AKI in hospitals, but their suitability for application in the community is unknown. METHODS: In a large renal cohort (n = 50 835) in one UK health authority, we applied the NHS England AKI 'e-alert' criteria to identify and follow three AKI groups: hospital-acquired AKI (HA-AKI), community-acquired AKI admitted to hospital within 7 days (CAA-AKI) and community-acquired AKI not admitted within 7 days (CANA-AKI)...
June 2016: Nephrology, Dialysis, Transplantation
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