Acute nierschade tijdens opname onvoldoende herkend

Objective

Describing diagnosis, treatment and follow-up of acute kidney injury (AKI) in patients at the VUmc on the basis of automated detection of elevated plasma creatinine.

Design

Retrospective study.

Method

All patients who were admitted to the VUmc during the period of 1 July 2016 to 31 December 2016 were included. The electronic patient records (EPRs) of these patients were analysed for AKI by an algorithm in which AKI was defined as plasma creatinine elevation of at least 27 μmol/l within 48 hours or more than 50% plasma creatinine elevation within 7 days in comparison with the baseline value. Patients with AKI were investigated to find out whether they were treated for this.

Results

The total of patients admitted during the period analysed was 10,932. At least two plasma creatinine values were known for 3,454 patients. There were 1 or more episodes of AKI for 330 admissions while the total number of AKI episodes was 427. AKI was not identified in 17.9% of patients, it was not treated in 31.8% of patients and there was no post-admission monitoring for 44.4% of patients.

Conclusion

This analysis shows there is room for improvement with respect to diagnosis and treatment as well as follow-up of AKI. Previous studies showed that intervention shortly after the onset of AKI led to improvement of kidney function and survival. Organising detection, treatment and follow-up of AKI in the hospital may lead to health improvement as well as cost reduction.

Conflict of interest and financial support: this study was funded by an innovation fund of the VUmc. ICMJE forms provided by the authors are available online along with the full text of this article.