Improving acute kidney injury diagnostics using predictive analytics

被引:9
作者
Basu, Rajit K. [1 ,2 ]
Gist, Katja [3 ]
Wheeler, Derek S. [1 ]
机构
[1] Univ Cincinnati, Cincinnati Childrens Hosp & Med Ctr, Ctr Acute Care Nephrol, Div Crit Care Med, Cincinnati, OH USA
[2] Univ Cincinnati, Cincinnati Childrens Hosp & Med Ctr, Ctr Acute Care Nephrol, Dept Pediat, Cincinnati, OH USA
[3] Univ Colorado, Dept Pediat, Childrens Hosp Colorado, Div Cardiol, Aurora, CO USA
关键词
biomarkers; clinical information systems; renal angina; risk stratification; ACUTE-RENAL-FAILURE; BIOMARKERS WORKGROUP STATEMENTS; RISK STRATIFICATION MODELS; FUROSEMIDE STRESS TEST; ELECTRONIC ALERT; PEDIATRIC RISK; MORTALITY; AKI; CHILDREN; TIME;
D O I
10.1097/MCC.0000000000000257
中图分类号
R4 [临床医学];
学科分类号
100218 [急诊医学];
摘要
Purpose of review Acute kidney injury (AKI) is a multifactorial syndrome affecting an alarming proportion of hospitalized patients. Although early recognition may expedite management, the ability to identify patients at-risk and those suffering real-time injury is inconsistent. The review will summarize the recent reports describing advancements in the area of AKI epidemiology, specifically focusing on risk scoring and predictive analytics. Recent findings In the critical care population, the primary underlying factors limiting prediction models include an inability to properly account for patient heterogeneity and underperforming metrics used to assess kidney function. Severity of illness scores demonstrate limited AKI predictive performance. Recent evidence suggests traditional methods for detecting AKI may be leveraged and ultimately replaced by newer, more sophisticated analytical tools capable of prediction and identification: risk stratification, novel AKI biomarkers, and clinical information systems. Additionally, the utility of novel biomarkers may be optimized through targeting using patient context, and may provide more granular information about the injury phenotype. Finally, manipulation of the electronic health record allows for real-time recognition of injury. Summary Integrating a high-functioning clinical information system with risk stratification methodology and novel biomarker yields a predictive analytic model for AKI diagnostics.
引用
收藏
页码:473 / 478
页数:6
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