Advancing the Use of Clinical Decision Support to Prevent Drug-Associated AKI

Clinical decision support (CDS) has repeatedly been successful in improving the physicians' drug prescribing for patients with kidney disease. Alerts aimed at drug dosing may address prevention of drug accumulation, but might miss situations when a high-risk patient still receives a nephrotoxin. Alert advancement requires CDS that is focused on the appropriate use of potentially nephrotoxic medications. Unfortunately, the literature is replete with examples of inaccurate or ineffective alerts. However, analyzing these efforts will allow us to advance CDS to be more effective and to better understand how to include early detection of drug-associated acute kidney injury. Attempts have been made to address these limitations of CDS, but there are still opportunities for improvement.