Health Record–Based Alert to Improve Recognition of AKI in Hospitalized Patients

A randomized trial suggests it does more harm than good for patients with acute kidney injury.

Acute kidney injury (AKI) in hospitalized patients is associated with poor outcomes but often is unrecognized. In this multicenter U.S. trial, researchers randomized more than 6000 adult inpatients with AKI (as defined by Kidney Disease: Improving Global Outcomes creatinine criteria) either to an electronic health record (EHR)–based “pop-up” provider alert for AKI or to usual care. The pop-up included an associated AKI order set with options for kidney imaging as well as blood and urine testing.

No differences between the two groups were noted in the composite outcome (i.e., progression of AKI, receipt of dialysis, or death within 14 days of randomization). Intravenous fluids and urinalysis were ordered more often in the alert arm, suggestin…

Reviewing Author

Andrew S. Parsons, MD, MPH

Disclosures

Consultant/Advisory BoardNEJM Healer Advisory Group; Aquifer Clinical Excellence; NBME Clinical Reasoning

Grant/Research SupportSouthern Group on Educational Affairs (SGEA)

Editorial BoardsDiagnosis

Leadership Positions in Professional SocietiesUndergraduate Medical Education (UME) Section Chair, Southern Group on Educational Affairs (SGEA); Chair of Early Career Physicians, American College of Physicians (ACP), Virginia Chapter

Andrew S. Parsons, MD, MPH

Disclosures

Consultant/Advisory BoardNEJM Healer Advisory Group; Aquifer Clinical Excellence; NBME Clinical Reasoning

Grant/Research SupportSouthern Group on Educational Affairs (SGEA)

Editorial BoardsDiagnosis

Health Record–Based Alert to Improve Recognition of AKI in Hospitalized Patients

Topics

Reviewing Author