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Community Health Care Quality Standards to Prevent Acute Kidney Injury and Its Consequences
Samuel A Silver1, Mitra K Nadim2, Donal J O'Donoghue3
1Division of Nephrology, Kingston Health Sciences Center, Queen's University, Kingston, Ont, Canada.
The American Journal of Medicine
|December 13, 2019
Summary
Preventing acute kidney injury (AKI) in the community is crucial. New guidelines recommend risk stratification and a Kidney Health Assessment for patients with potential AKI exposures, enabling early intervention.
Area of Science:
- Nephrology
- Public Health
- Healthcare Quality Improvement
Background:
- Rising incidence of acute kidney injury (AKI) necessitates community-based prevention.
- A knowledge gap exists in quality-of-care measurement for AKI prevention.
- The 22nd Acute Disease Quality Initiative (ADQI) addressed community AKI prevention.
Purpose of the Study:
- To develop a framework for identifying and monitoring community-based AKI.
- To propose evidence-based quality-of-care measures for AKI prevention.
- To provide actionable recommendations for community healthcare providers.
Main Methods:
- Modified Delphi process involving an international, interdisciplinary group.
- Development of a risk stratification model incorporating patient susceptibilities and exposures.
- Definition of a Kidney Health Assessment and Kidney Health Response protocol.
Main Results:
- A framework for community AKI identification and monitoring was established.
- Recommendations include risk stratification using chronic kidney disease and exposures like coronary angiography.
- A Kidney Health Assessment (blood pressure, creatinine, urine dipstick) and Response (medication review, nephrotoxin minimization) were proposed.
Conclusions:
- The ADQI 22nd recommendations offer a starting point for community AKI prevention quality improvement.
- Implementing these strategies can help prevent AKI and its consequences.
- Community healthcare providers and systems can utilize these guidelines for enhanced patient care.
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