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Community Acquired AKI

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32 papers 0 to 25 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29436439/the-national-early-warning-score-and-its-subcomponents-recorded-within-%C3%A2-24-h-of-emergency-medical-admission-are-poor-predictors-of-hospital-acquired-acute-kidney-injury
#1
Muhammad Faisal, Andy Scally, Musab Ahmed Elgaali, Donald Richardson, Kevin Beatson, Mohammed A Mohammed
Hospital-acquired acute kidney injury (H-AKI) is a common cause of avoidable morbidity and mortality. Therefore , in the current study, we investigated whether vital signs data from patients, as defined by a National Early Warning Score (NEWS), can predict H-AKI following emergency admission to hospital. We analysed all emergency admissions (n=33,608) to York Hospital with NEWS data over a 24-month period. Here, we report the area under the curve (AUC) for logistic regression models that used the index NEWS (model A0), plus age and sex (A1), plus subcomponents of NEWS (A2) and two-way interactions (A3), and similarly for maximum NEWS (models B0,B1,B2,B3)...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29361145/adding-a-new-dimension-to-the-weekend-effect-an-analysis-of-a-national-data-set-of-electronic-aki-alerts
#2
Jennifer Holmes, Timothy Rainer, John Geen, John D Williams, Aled O Phillips
Background: Increased mortality related to differences in delivery of weekend clinical care is the subject of much debate. Aims: We compared mortality following detection of AKI on week and weekend days across community and hospital settings. Design. A prospective national cohort study, with AKI identified using the Welsh National electronic AKI reporting system. Methods: Data was collected on outcome for all cases of adult AKI in Wales between 1st November 2013 and 31st January 2017...
January 17, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29314467/admission-calcium-levels-and-risk-of-acute-kidney-injury-in-hospitalised-patients
#3
Charat Thongprayoon, Wisit Cheungpasitporn, Michael A Mao, Ankit Sakhuja, Stephen B Erickson
BACKGROUND: The risk of acute kidney injury (AKI) development among hospitalised patients with elevated calcium levels on admission remains unclear. The aim of this study was to assess the risk of AKI in hospitalised patients stratified by various admission serum calcium levels. METHODS: This is a single-centre retrospective study conducted at a tertiary referral hospital. All hospitalised adult patients who had admission calcium levels available between 2009 and 2013 were enrolled...
January 5, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29287584/risk-factors-for-community-acquired-acute-kidney-injury-in-patients-with-and-without-chronic-kidney-injury-and-impact-of-its-initial-management-on-prognosis-a-prospective-observational-study
#4
Fabien Stucker, Belen Ponte, Victoria De la Fuente, Cyrielle Alves, Olivier Rutschmann, Sebastian Carballo, Nicolas Vuilleumier, Pierre-Yves Martin, Thomas Perneger, Patrick Saudan
BACKGROUND: We aimed to describe clinical characteristics of patients with community-acquired acute kidney injury (CA-AKI), the effectiveness of initial management of CA-AKI, its prognosis and the impact of medication on its occurrence in patients with previous chronic kidney injury (CKI). METHODS: We undertook a prospective observational study within the Emergency Department (ED) of a University Hospital, screening for any patient >16 years admitted with an eGFR <60 ml/mn/1...
December 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29265039/a-pragmatic-randomized-controlled-trial-comparing-pathway-based-versus-usual-care-in-community-acquired-acute-kidney-injury
#5
Abdullah H Almalki, Sherine E Ismail, Mohammad A Qureshi, Zuhair Abunijem, Mohamed E Balla, Saliman Karsou, Rehan A Qureshi, Akram Ahmad, Salhah AlSulami, Maryam Khalil, Jani Hafez, Jane E H Thomson, Muhammad A Siddiqui, Oyindamola B Yusuf, Zeyad A Zahrani, Abdulhameed Gasim, K H Mujtaba Quadri
Clinical pathways have shown conflicting evidence in improvement of several patient-centered outcomes across different clinical settings. However, the effectiveness of clinical pathway in management of acute kidney injury (AKI) has not been reported. Therefore, we aimed to assess the length of hospital stay (LOS) and patient-centered outcomes in community acquired AKI and compared pathway care (PC) versus usual care (UC). The CHAMP-Path AKI Trial is a pragmatic, parallel, single-blind randomized controlled trial...
November 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/29155805/epidemiology-and-outcomes-of-community-acquired-and-hospital-acquired-acute-kidney-injury-in-children-and-adolescents
#6
Chien-Ning Hsu, Hsiao-Ling Chen, You-Lin Tain
BACKGROUND: Hospital-acquired acute kidney injury (HA-AKI) is associated with an increased risk of childhood mortality; however, only a few studies have addressed community-acquired AKI (CA-AKI). METHODS: AKI Network classification was used to assess community- and hospital-acquired AKI, 2010-2014. Patients with CA-AKI who were admitted to an inpatient setting were categorized as CAA-AKI. CANA-AKI was for CA-AKI not admitted to inpatient care. Epidemiology, factors associated with AKI, in-hospital outcomes were assessed for variation...
November 20, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29145061/utility-of-electronic-aki-alerts-in-intensive-care-a-national-multicentre-cohort-study
#7
Jennifer Holmes, Gethin Roberts, John Geen, Alan Dodd, Nicholas M Selby, Andrew Lewington, Gareth Scholey, John D Williams, Aled O Phillips
BACKGROUND: Electronic AKI alerts highlight changes in serum creatinine compared to the patient's own baseline. Our aim was to identify all AKI alerts and describe the relationship between electronic AKI alerts and outcome for AKI treated in the Intensive Care Unit (ICU) in a national multicentre cohort. METHODS: A prospective cohort study was undertaken between November 2013 and April 2016, collecting data on electronic AKI alerts issued. RESULTS: 10% of 47,090 incident AKI alerts were associated with ICU admission...
October 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29142963/understanding-electronic-aki-alerts-characterization-by-definitional-rules
#8
Jennifer Holmes, Gethin Roberts, Soma Meran, John D Williams, Aled O Phillips
Introduction: Automated acute kidney injury (AKI) electronic alerts are based on comparing creatinine with historic results. Methods: We report the significance of AKI defined by 3 "rules" differing in the time period from which the baseline creatinine is obtained, and AKI with creatinine within the normal range. Results: A total of 47,090 incident episodes of AKI occurred between November 2013 and April 2016. Rule 1 (>26 μmol/l increase in creatinine within 48 hours) accounted for 9...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29066767/incidence-and-risk-factors-of-in-hospital-mortality-from-aki-after-non-cardiovascular-operation-a-nationwide-survey-in-china
#9
Yu Pan, Wenji Wang, Jinwei Wang, Li Yang, Feng Ding
This study aimed to describe the mortality and risk factors of in-hospital mortality from acute kidney injury (AKI) after non-cardiovascular operation in China based on a nationwide survey about AKI. The study sample was drawn from ISN AKF 0by25 China Consortiums, which is a nationwide, cross-sectional survey from 22 provinces in mainland China. AKI after non-cardiovascular operation was identified according to the 2012 KDIGO AKI creatinine criteria or expanded criteria. In total, 3468 cases were identified as hospital-acquired AKI (HA-AKI)...
October 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29058639/hospital-acquired-acute-kidney-injury-is-associated-with-increased-mortality-but-not-increased-readmission-rates-in-a-uk-acute-hospital
#10
Nerissa Jurawan, Tanya Pankhurst, Charles Ferro, Peter Nightingale, Jamie Coleman, David Rosser, Simon Ball
BACKGROUND: Acute Kidney Injury (AKI) has evoked much interest over the past decade and is reported to be associated with high inpatient mortality. Preventable death and increased readmission rates related to AKI have been the focus of considerable interest. METHODS: We studied hospital acquired AKI in all emergency hospital admissions, except transfers from ICU to ICU or patients known to renal services, to ascertain mortality and readmission rates, and trackable modifiable factors for death, using cox regression and Kaplan Meier survival curves...
October 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29025142/community-acquired-acute-kidney-injury-findings-from-a-large-population-cohort
#11
J Holmes, J Geen, B Phillips, J D Williams, A O Phillips
Background: The extent of patient contact with medical services prior to development of community acquired-acute kidney injury (CA-AKI)is unknown. Aim: We examined the relationship between incident CA-AKI alerts, previous contact with hospital or primary care and clinical outcomes. Design: A prospective national cohort study of all electronic AKIalerts representing adult CA-AKI. Methods: Data were collected for all cases of adult (≥18 years of age) CA-AKI in Wales between 1 November 2013 and 31 January 2017...
July 21, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28963291/systematic-review-of-prognostic-prediction-models-for-acute-kidney-injury-aki-in-general-hospital-populations
#12
Luke Eliot Hodgson, Alexander Sarnowski, Paul J Roderick, Borislav D Dimitrov, Richard M Venn, Lui G Forni
OBJECTIVE: Critically appraise prediction models for hospital-acquired acute kidney injury (HA-AKI) in general populations. DESIGN: Systematic review. DATA SOURCES: Medline, Embase and Web of Science until November 2016. ELIGIBILITY: Studies describing development of a multivariable model for predicting HA-AKI in non-specialised adult hospital populations. Published guidance followed for data extraction reporting and appraisal...
September 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28737132/differences-in-characteristics-and-outcomes-between-community-and-hospital-acquired-acute-kidney-injury-a-systematic-review-and-meta-analysis%C3%A2
#13
Ryota Inokuchi, Yoshitaka Hara, Hideo Yasuda, Noritomo Itami, Yoshio Terada, Kent Doi
INTRODUCTION: No comprehensive review has examined the difference between community-acquired (CA) and hospital-acquired (HA) acute kidney injury (AKI) in terms of patient characteristics, in-hospital mortality, and hospital stay length. MATERIALS AND METHODS: We conducted a systematic review and meta-analysis of observational studies, using MEDLINE, EMBASE, Web of Science, Google Scholar, and the Cochrane Library from their inceptions to April 10, 2016. Observational studies that (1) were published in peer-reviewed journals; (2) compared CA-AKI with HA-AKI, irrespective of the AKI definition during the same period; and (3) investigated in-hospital mortality and length of hospital stay were studied...
July 24, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28607684/a-multifaceted-quality-improvement-programme-to-improve-acute-kidney-injury-care-and-outcomes-in-a-large-teaching-hospital
#14
Leonard Ebah, Prasanna Hanumapura, Deryn Waring, Rachael Challiner, Katharine Hayden, Jill Alexander, Robert Henney, Rachel Royston, Cassian Butterworth, Marc Vincent, Susan Heatley, Ged Terriere, Robert Pearson, Alastair Hutchison
Acute kidney injury (AKI) is now widely recognised as a serious health care issue, occurring in up to 25% of hospital in-patients, often with worsening of outcomes. There have been several reports of substandard care in AKI. This quality improvement (QI) programme aimed to improve AKI care and outcomes in a large teaching hospital. Areas of documented poor AKI care were identified and specific improvement activities implemented through sequential Plan-Do-Study-Act (PDSA) cycles. An electronic alert system (e-alert) for AKI was developed, a Priority Care Checklist (PCC) was tested with the aid of specialist nurses whilst targeted education activities were carried out and data on care processes and outcomes monitored...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28570592/a-prospective-study-of-the-demographics-management-and-outcome-of-patients-with-acute-kidney-injury-in-cape-town-south-africa
#15
Thandiwe A L Dlamini, Peter J Heering, Tawanda Chivese, Brian Rayner
AIM: To study the demographics and outcome of acute kidney injury (AKI) at Groote Schuur Hospital, Cape Town, South Africa. METHODS AND FINDINGS: A prospective observational study of AKI fulfilling the Kidney Disease: Improving Global Outcomes definition, from 8 July 2012 to 8 July 2013. Ethics approval was granted by the University of Cape Town Human Research Ethics Committee. Consent was waived because patient data was de-identified and patient management was not adversely affected by the study...
2017: PloS One
https://www.readbyqxmd.com/read/28495862/the-diagnosis-wide-landscape-of-hospital-acquired-aki
#16
Anne-Sophie Jannot, Anita Burgun, Eric Thervet, Nicolas Pallet
BACKGROUND AND OBJECTIVES: The exploration of electronic hospital records offers a unique opportunity to describe in-depth the prevalence of conditions associated with diagnoses at an unprecedented level of comprehensiveness. We used a diagnosis-wide approach, adapted from phenome-wide association studies (PheWAS), to perform an exhaustive analysis of all diagnoses associated with hospital-acquired AKI (HA-AKI) in a French urban tertiary academic hospital over a period of 10 years. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We retrospectively extracted all diagnoses from an i2b2 (Informatics for Integrating Biology and the Bedside) clinical data warehouse for patients who stayed in this hospital between 2006 and 2015 and had at least two plasma creatinine measurements performed during the first week of their stay...
June 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28343224/the-evidence-of-acute-kidney-injury-in-the-community-and-for-primary-care-interventions
#17
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...
2017: Nephron
https://www.readbyqxmd.com/read/28274964/predicting-aki-in-emergency-admissions-an-external-validation-study-of-the-acute-kidney-injury-prediction-score-aps
#18
L E Hodgson, B D Dimitrov, P J Roderick, R Venn, L G Forni
OBJECTIVES: Hospital-acquired acute kidney injury (HA-AKI) is associated with a high risk of mortality. Prediction models or rules may identify those most at risk of HA-AKI. This study externally validated one of the few clinical prediction rules (CPRs) derived in a general medicine cohort using clinical information and data from an acute hospitals electronic system on admission: the acute kidney injury prediction score (APS). DESIGN, SETTING AND PARTICIPANTS: External validation in a single UK non-specialist acute hospital (2013-2015, 12 554 episodes); four cohorts: adult medical and general surgical populations, with and without a known preadmission baseline serum creatinine (SCr)...
March 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/27658322/the-risk-of-chronic-kidney-disease-and-mortality-are%C3%A2-increased-after-community-acquired-acute-kidney-injury
#19
Karina Soto, Pedro Campos, Iola Pinto, Bruno Rodrigues, Francisca Frade, Ana Luísa Papoila, Prasad Devarajan
We investigated whether community-acquired acute kidney injury encountered in a tertiary hospital emergency department setting increases the risk of chronic kidney disease (CKD) and mortality, and whether plasma biomarkers could improve the prediction of those adverse outcomes. In a prospective cohort study, we enrolled 616 patients at admission to the emergency department and followed them for a median of 62.1 months. Within this cohort, 130 patients were adjudicated as having acute kidney injury, 159 transient azotemia, 15 stable CKD, and 312 normal renal function...
November 2016: Kidney International
https://www.readbyqxmd.com/read/28088183/incidence-aetiology-and-outcome-of-community-acquired-acute-kidney-injury-in-medical-admissions-in-malawi
#20
Rhys D R Evans, Ulla Hemmilä, Alison Craik, Mwayi Mtekateka, Fergus Hamilton, Zuze Kawale, Christopher J Kirwan, Hamish Dobbie, Gavin Dreyer
BACKGROUND: Epidemiological data on Acute Kidney Injury (AKI) from low-income countries is sparse. The aim of this study was to establish the incidence, severity, aetiology, and outcomes of community-acquired AKI in Malawi. METHODS: We conducted a prospective observational study of general medical admissions to a tertiary hospital in Blantyre between 27th April and 17th July 2015. All patients were screened on admission with a serum creatinine; those with creatinine above laboratory reference range were managed by the nephrology team...
January 14, 2017: BMC Nephrology
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