Artificial Intelligence for AKI!Now: Let’s Not Await Plato’s Utopian Republic

Soranno, Danielle E.; Goldstein, Stuart L.; Kashani, Kianoush; Menon, Shina; Nadkarni, Girish N.; Neyra, Javier A.; Pannu, Neesh; Singh, Karandeep; Cerdá, Jorge; Koyner, Jay L.

doi:10.34067/kid.0003472021

Cited by 15 publications

(8 citation statements)

References 40 publications

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“…To date, most of the work has focused on using artificial intelligence (AI) (e.g., machine learning) to predict and prognosticate short-term outcomes after AKI with less work investigating specific interventions related to the care of AKI survivors. 67,68 While availability of electronic health record data underpins opportunities for personalized risk stratification, complex syndromes, such as AKI, may require more precise biologic subphenotyping for tailored interventions. For example, AKI linked to systemic inflammation in a critically ill patient may have different pathobiological recovery processes than other types of AKI with minimal inflammation.…”

Section: Digital Health Applicationsmentioning

confidence: 99%

Optimum Care of AKI Survivors Not Requiring Dialysis after Discharge: An AKINow Recovery Workgroup Report

Barreto,

Cerda,

Freshly

et al. 2023

Kidney360

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Acute kidney injury (AKI) affects one in five hospitalized patients and is associated with poor short- and long-term clinical and patient-centered outcomes. Among those who survive to discharge, significant gaps in documentation, education, communication, and follow-up have been observed. The American Society of Nephrology established the AKINow taskforce to address these gaps and improve AKI care. The AKINow Recovery workgroup convened two focus groups, one each focused on dialysis-independent and dialysis-requiring AKI, to summarize the key considerations, challenges, and opportunities in the care of AKI survivors. This manuscript highlights the discussion surrounding care of AKI survivors discharged without the need for dialysis. On May 3, 2022, 48 patients and multidisciplinary clinicians from diverse settings were gathered virtually. The agenda included a patient testimonial, plenary sessions, facilitated small group discussions and debriefing. Core challenges and opportunities for AKI care identified were in the domains of transitions of care, education, collaborative care delivery, diagnostic and therapeutic interventions, and digital health applications. Integrated multispecialty care delivery was identified as one of the greatest challenges to AKI survivor care. Adequate templates for communication and documentation, education of patients, care partners, and clinicians about AKI, and a well-coordinated multidisciplinary post-hospital follow-up plan form the basis for a successful care transition at hospital discharge. The AKINow Recovery workgroup concluded that advancements in evidence-based, patient-centered care of AKI survivors are needed to improve health outcomes, care quality, and patient and provider experience. Tools are being developed by the AKINow Recovery workgroup for use at the hospital discharge to facilitate care continuity.

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Section: Digital Health Applicationsmentioning

confidence: 99%

Optimum Care of AKI Survivors Not Requiring Dialysis after Discharge: An AKINow Recovery Workgroup Report

Barreto,

Cerda,

Freshly

et al. 2023

Kidney360

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“…There are many opportunities to leverage the power of AI to recognize and phenotype AKI and to improve the care and follow-up of AKI patients. The AI working group of the AKI!Now initiative of the American Society of Nephrology represents the growing momentum in this field and ongoing collaborative efforts to use data science and quality initiatives to improve early recognition and treatment of AKI and to reduce the disease burden on patients and health systems (110,111).…”

Section: Artificial Intelligence/informaticsmentioning

confidence: 99%

Overview of Diagnostic Criteria and Epidemiology of Acute Kidney Injury and Acute Kidney Disease in the Critically Ill Patient

Birkelo¹,

Pannu

Siew

2022

CJASN

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Since the description ischuria renalis by William Heberden (1), AKI has remained a prominent complication of critical illness. Beyond KRT, treatment has been limited by the capacity to phenotype this condition. Here, we chronicle the evolution of attempts to classify AKI, including the adoption of consensus definitions, the expansion of diagnosis and prognosis with novel biomarkers, and emerging tools such as artificial intelligence (AI).

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“…16 The success of the NINJA program in the pediatric population has prompted calls from the American Society of Nephrology and others for further validation in adult populations. 17,18 To prepare for potential implementation in adults, we retrospectively used the NINJA screening tool in adults to determine rates of nephrotoxic AKI in adults using the NINJA definition and to determine the most frequently used nephrotoxin regimens, and we used statistical analyses to determine whether high nephrotoxic exposure associates with AKI.…”

Section: Introductionmentioning

confidence: 99%

Nephrotoxin Exposure and Acute Kidney Injury in Adults

Griffin

Wendt

Vaughan‐Sarrazin

et al. 2023

CJASN

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Background Rates of nephrotoxic AKI are not well described in adults due to lack of a clear definition, debate over which drugs should be considered nephrotoxins, and illness-related confounding. Nephrotoxic Injury Negated by Just-in Time Action (NINJA), a program that reduces rates of nephrotoxic AKI in pediatric populations, may be able to address these concerns, but whether NINJA can be effectively applied to adults remains unclear.Methods In this retrospective cohort study conducted at the University of Iowa Hospital, we included adult patients admitted to a general hospital floor for $48 hours during 2019. The NINJA algorithm screened charts for high nephrotoxin exposure and AKI. After propensity score matching, Cox proportional hazard modeling was used to evaluate the relationship between nephrotoxic exposure and all-stage AKI, stage 2-3 AKI, or death. Additional analyses evaluated the most frequent nephrotoxins used in this population.Results Of 11,311 patients, 1527 (16%) had $1 day of high nephrotoxin exposure. Patients with nephrotoxic exposures subsequently developed AKI in 29% of cases, and 22% of all inpatient AKI events met nephrotoxic AKI criteria. Common nephrotoxins were vancomycin, iodinated contrast dye, piperacillin-tazobactam, acyclovir, and lisinopril. After propensity score matching, Cox proportional hazard models for high nephrotoxin exposure were significantly associated with all AKI (hazard ratio [

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Artificial Intelligence for AKI!Now: Let’s Not Await Plato’s Utopian Republic

Abstract: This is an Early Access article. Please select the PDF button, above, to view it.

Cited by 15 publications

References 40 publications

Optimum Care of AKI Survivors Not Requiring Dialysis after Discharge: An AKINow Recovery Workgroup Report

Optimum Care of AKI Survivors Not Requiring Dialysis after Discharge: An AKINow Recovery Workgroup Report

Overview of Diagnostic Criteria and Epidemiology of Acute Kidney Injury and Acute Kidney Disease in the Critically Ill Patient

Nephrotoxin Exposure and Acute Kidney Injury in Adults

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