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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Care Bundle for Acute Kidney Injury in Cardiac Patients: A Cluster-Randomized Trial
Ragna Iwers1,2, Veronika Sliziuk3, Michael Haase4,5,6
1Department of Cardiology, Heart Center Brandenburg Bernau & Faculty of Health Sciences (FGW) Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Ladeburger Str. 17, 16321 Bernau bei Berlin, Germany.
Journal of Clinical Medicine
|October 14, 2023
Summary
Electronic alerts for acute kidney injury (AKI) improved documentation and medication management but did not significantly alter patient outcomes in cardiac patients. Further research is needed to enhance patient-related endpoints.
Area of Science:
- Nephrology
- Cardiology
- Health Informatics
Background:
- Acute kidney injury (AKI) detection and intervention pose global challenges.
- Electronic alerts and care bundles show potential for improving AKI management.
- Evaluating these interventions in patients with cardiac diseases is crucial.
Purpose of the Study:
- To assess the efficacy of an electronic AKI alert system combined with a care bundle.
- To determine the impact on process- and patient-related endpoints in cardiac patients with AKI.
Main Methods:
- A two-arm, prospective, cluster-randomized controlled trial (RCT).
- Enrolled 200 patients with AKI (KDIGO criteria) and cardiac diseases.
- Assigned patients to routine care or an intervention group with electronic alerts and a care bundle.
Main Results:
- No significant difference in the primary endpoint (eGFR change) between groups.
- Improved documentation of AKI diagnosis and discharge summaries in the intervention group.
- More frequent cessation of antihypertensive medication during hypotension in the intervention group.
Conclusions:
- The electronic AKI alert system and care bundle enhanced process measures, such as documentation and medication management.
- Patient-related outcomes, including eGFR decline, were not significantly improved.
- Future strategies should focus on optimizing electronic alert systems to positively impact patient outcomes in AKI.
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