Establishing a continuum of acute kidney injury - tracing AKI using data source linkage and long-term follow-up: Workgroup Statements from the 15th ADQI Consensus Conference.
Establishing a continuum of acute kidney injury - tracing AKI using data source linkage and long-term follow-up: Workgroup Statements from the 15th ADQI Consensus Conference.
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DOI：
10.1186/s40697-016-0102-0
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发表时间：
2016
影响因子：
1.7
通讯作者：
Acute Dialysis Quality Initiative (ADQI) Consensus Group
中科院分区：
文献类型：
--
作者：
Mehta R;Bihorac A;Selby NM;Quan H;Goldstein SL;Kellum JA;Ronco C;Bagshaw SM;Acute Dialysis Quality Initiative (ADQI) Consensus Group
急性肾损伤 (AKI) 与慢性肾病、终末期肾病以及全因死亡率和心血管特异性死亡率的增加独立相关。肾损伤的严重程度和多次 AKI 发作的发生会增加发生这些结果的风险。尽管存在这些长期影响，但只有少数患者在 AKI 发作后接受肾病专家随访；那些这样做的人可能会取得更好的结果。此外，相对简单的质量改进策略有可能改变这种现状。在此背景下，第 15 届急性透析质量倡议 (ADQI) 会议的工作组应用了通过审查 PubMed 搜索确定的英文文章而形成共识的流程，以解决电子健康记录和大数据时代 AKI 患者纵向随访的机会、方法要求和障碍相关的问题。制定了四项共识声明来回答工作组确定的关键问题。我们已经确定了追踪患者从 AKI 发病到长期结果的自然史所需的最少数据元素和潜在数据源。概述了实现这些目标的最低基础设施和主要障碍以及建议的解决方案。
Acute kidney injury (AKI) is independently associated with the development of chronic kidney disease, endstage kidney disease and increased all-cause and cardiovascular-specific mortality. The severity of the renal insult and the development of multiple AKI episodes increase the risk of occurrence of these outcomes. Despite these long-term effects, only a minority of patients receive nephrologist follow up after an episode of AKI; those that do may have improved outcomes. Furthermore, relatively simple quality improvement strategies have the potential to change this status quo. On this background, a working group of the 15th Acute Dialysis Quality Initiative (ADQI) conference applied the consensus-building process informed by review of English language articles identified through PubMed search to address questions related to the opportunities, methodological requirements and barriers for longitudinal follow-up of patients with AKI in the era of electronic health records and Big Data. Four consensus statements answering the key questions identified by the working group are developed. We have identified minimal data elements and potential data sources necessary to trace the natural history of patients from onset of AKI to long-term outcome. Minimum infrastructure and key barriers to achieving these goals are outlined together with proposed solutions.