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Kashani KB, Awdishu L, Bagshaw SM, Barreto EF, Claure-Del Granado R, Evans BJ, Forni LG, Ghosh E, Goldstein SL, Kane-Gill SL, Koola J, Koyner JL, Liu M, Murugan R, Nadkarni GN, Neyra JA, Ninan J, Ostermann M, Pannu N, Rashidi P, Ronco C, Rosner MH, Selby NM, Shickel B, Singh K, Soranno DE, Sutherland SM, Bihorac A, Mehta RL. Digital health and acute kidney injury: consensus report of the 27th Acute Disease Quality Initiative workgroup. Nat Rev Nephrol 2023; 19:807-818. [PMID: 37580570 DOI: 10.1038/s41581-023-00744-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/16/2023]
Abstract
Acute kidney injury (AKI), which is a common complication of acute illnesses, affects the health of individuals in community, acute care and post-acute care settings. Although the recognition, prevention and management of AKI has advanced over the past decades, its incidence and related morbidity, mortality and health care burden remain overwhelming. The rapid growth of digital technologies has provided a new platform to improve patient care, and reports show demonstrable benefits in care processes and, in some instances, in patient outcomes. However, despite great progress, the potential benefits of using digital technology to manage AKI has not yet been fully explored or implemented in clinical practice. Digital health studies in AKI have shown variable evidence of benefits, and the digital divide means that access to digital technologies is not equitable. Upstream research and development costs, limited stakeholder participation and acceptance, and poor scalability of digital health solutions have hindered their widespread implementation and use. Here, we provide recommendations from the Acute Disease Quality Initiative consensus meeting, which involved experts in adult and paediatric nephrology, critical care, pharmacy and data science, at which the use of digital health for risk prediction, prevention, identification and management of AKI and its consequences was discussed.
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Affiliation(s)
- Kianoush B Kashani
- Division of Nephrology and Hypertension, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Linda Awdishu
- Clinical Pharmacy, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA
| | - Sean M Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, Canada
| | | | - Rolando Claure-Del Granado
- Division of Nephrology, Hospital Obrero No 2 - CNS, Cochabamba, Bolivia
- Universidad Mayor de San Simon, School of Medicine, Cochabamba, Bolivia
| | - Barbara J Evans
- Intelligent Critical Care Center, University of Florida, Gainesville, FL, USA
| | - Lui G Forni
- Department of Critical Care, Royal Surrey Hospital NHS Foundation Trust & Department of Clinical & Experimental Medicine, University of Surrey, Guildford, UK
| | - Erina Ghosh
- Philips Research North America, Cambridge, MA, USA
| | - Stuart L Goldstein
- Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sandra L Kane-Gill
- Biomedical Informatics and Clinical Translational Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jejo Koola
- UC San Diego Health Department of Biomedical Informatics, Department of Medicine, La Jolla, CA, USA
| | - Jay L Koyner
- Section of Nephrology, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Mei Liu
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Raghavan Murugan
- The Program for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- The Clinical Research, Investigation, and Systems Modelling of Acute Illness Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Girish N Nadkarni
- Division of Data-Driven and Digital Medicine (D3M), Department of Medicine, Icahn School of Medicine at Mount Sinai; Mount Sinai Clinical Intelligence Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Javier A Neyra
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jacob Ninan
- Division of Pulmonary, Critical Care and Sleep Medicine, Mayo Clinic, Rochester, MN, USA
| | - Marlies Ostermann
- Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, UK
| | - Neesh Pannu
- Division of Nephrology, University of Alberta, Edmonton, Canada
| | - Parisa Rashidi
- Intelligent Critical Care Center, University of Florida, Gainesville, FL, USA
| | - Claudio Ronco
- Università di Padova; Scientific Director Foundation IRRIV; International Renal Research Institute; San Bortolo Hospital, Vicenza, Italy
| | - Mitchell H Rosner
- Department of Medicine, University of Virginia Health, Charlottesville, VA, USA
| | - Nicholas M Selby
- Centre for Kidney Research and Innovation, Academic Unit of Translational Medical Sciences, University of Nottingham, Nottingham, UK
- Department of Renal Medicine, Royal Derby Hospital, Derby, UK
| | - Benjamin Shickel
- Intelligent Critical Care Center, University of Florida, Gainesville, FL, USA
| | - Karandeep Singh
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Danielle E Soranno
- Section of Nephrology, Department of Pediatrics, Indiana University, Riley Hospital for Children, Indianapolis, IN, USA
| | - Scott M Sutherland
- Division of Nephrology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Azra Bihorac
- Intelligent Critical Care Center, University of Florida, Gainesville, FL, USA.
| | - Ravindra L Mehta
- Division of Nephrology-Hypertension, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
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Clermont G. The Learning Electronic Health Record. Crit Care Clin 2023; 39:689-700. [PMID: 37704334 DOI: 10.1016/j.ccc.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Electronic medical records (EMRs) constitute the electronic version of all medical information included in a patient's paper chart. The electronic health record (EHR) technology has witnessed massive expansion in developed countries and to a lesser extent in underresourced countries during the last 2 decades. We will review factors leading to this expansion, how the emergence of EHRs is affecting several health-care stakeholders; some of the growing pains associated with EHRs with a particular emphasis on the delivery of care to the critically ill; and ongoing developments on the path to improve the quality of research, health-care delivery, and stakeholder satisfaction.
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Affiliation(s)
- Gilles Clermont
- VA Pittsburgh Medical Center, 1054 Aliquippa Street, Pittsburgh, PA 15104, USA; Critical Care Medicine, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15061, USA.
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Atia J, Evison F, Gallier S, Hewins P, Ball S, Gavin J, Coleman J, Garrick M, Pankhurst T. Does acute kidney injury alerting improve patient outcomes? BMC Nephrol 2023; 24:14. [PMID: 36647011 PMCID: PMC9843843 DOI: 10.1186/s12882-022-03031-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/05/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Electronic alerts (e-alerts) for Acute Kidney Injury (AKI) have been implemented into a variety of different Electronic Health Records (EHR) systems worldwide in order to improve recognition and encourage early appropriate management of AKI. We were interested in the impact on patient safety, specialist referral and clinical management. METHODS All patients admitted to our institution with AKI were included in the study. We studied AKI progression, dialysis dependency, length of hospital stay, emergency readmission, ICU readmission, and death, before and after the introduction of electronic alerts. The impact on prescription of high risk drugs, fluid administration, and referral to renal services was also analysed. RESULTS After the introduction of the e-alert, progression to higher AKI stage, emergency readmission to hospital and death during admission were significantly reduced. More prescriptions were stopped for drugs that adversely affect renal function in AKI and there was a significant increase in the ICU admissions and in the number of patients having dialysis, especially in earlier stages. Longer term mortality, renal referrals, and fluid alteration did not change significantly after the AKI e-alert introduction. CONCLUSIONS AKI e-alerts can improve clinical outcomes in hospitalised patients.
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Affiliation(s)
- Jolene Atia
- grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK ,grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Institute of Translational Medicine, Edgbaston, Birmingham, UK
| | - Felicity Evison
- grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK ,grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Institute of Translational Medicine, Edgbaston, Birmingham, UK
| | - Suzy Gallier
- grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK ,grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Institute of Translational Medicine, Edgbaston, Birmingham, UK ,grid.6572.60000 0004 1936 7486PIONEER: HDR-UK Health Data Research Hub for Acute Care, University of Birmingham, Birmingham, UK
| | - Peter Hewins
- grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Simon Ball
- grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK ,grid.6572.60000 0004 1936 7486HDRUK Better Care Science Priority and Health Data Research UK Midlands, University of Birmingham, Birmingham, UK
| | - Joseph Gavin
- grid.415953.f0000 0004 0400 1537Lister Hospital, Stevenage, UK
| | - Jamie Coleman
- grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK ,grid.6572.60000 0004 1936 7486School of Medicine, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Mark Garrick
- grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Tanya Pankhurst
- grid.412563.70000 0004 0376 6589University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK ,grid.415490.d0000 0001 2177 007XQueen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2TH UK
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Zhao Y, Zheng X, Wang J, Xu D, Li S, Lv J, Yang L. Effect of clinical decision support systems on clinical outcome for acute kidney injury: a systematic review and meta-analysis. BMC Nephrol 2021; 22:271. [PMID: 34348688 PMCID: PMC8335454 DOI: 10.1186/s12882-021-02459-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 06/25/2021] [Indexed: 12/11/2022] Open
Abstract
Background Clinical decision support systems including both electronic alerts and care bundles have been developed for hospitalized patients with acute kidney injury. Methods Electronic databases were searched for randomized, before-after and cohort studies that implemented a clinical decision support system for hospitalized patients with acute kidney injury between 1990 and 2019. The studies must describe their impact on care processes, patient-related outcomes, or hospital length of stay. The clinical decision support system included both electronic alerts and care bundles. Results We identified seven studies involving 32,846 participants. Clinical decision support system implementation significantly reduced mortality (OR 0.86; 95 % CI, 0.75–0.99; p = 0.040, I2 = 65.3 %; n = 5 studies; N = 30,791 participants) and increased the proportion of acute kidney injury recognition (OR 3.12; 95 % CI, 2.37–4.10; p < 0.001, I2 = 77.1 %; n = 2 studies; N = 25,121 participants), and investigations (OR 3.07; 95 % CI, 2.91–3.24; p < 0.001, I2 = 0.0 %; n = 2 studies; N = 25,121 participants). Conclusions Nonrandomized controlled trials of clinical decision support systems for acute kidney injury have yielded evidence of improved patient-centered outcomes and care processes. This review is limited by the low number of randomized trials and the relatively short follow-up period. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-021-02459-y.
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Affiliation(s)
- Youlu Zhao
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, 8 Xishiku ST, Xicheng District, 100034, Beijing, People's Republic of China
| | - Xizi Zheng
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, 8 Xishiku ST, Xicheng District, 100034, Beijing, People's Republic of China
| | - Jinwei Wang
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, 8 Xishiku ST, Xicheng District, 100034, Beijing, People's Republic of China
| | - Damin Xu
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, 8 Xishiku ST, Xicheng District, 100034, Beijing, People's Republic of China
| | - Shuangling Li
- Surgical Intensive Care Unit, Peking University First Hospital, Beijing, China
| | - Jicheng Lv
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, 8 Xishiku ST, Xicheng District, 100034, Beijing, People's Republic of China.
| | - Li Yang
- Renal Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China; Research Units of Diagnosis and Treatment of Immune-mediated Kidney Diseases, Chinese Academy of Medical Sciences, 8 Xishiku ST, Xicheng District, 100034, Beijing, People's Republic of China.
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Chew CKT, Hogan H, Jani Y. Scoping review exploring the impact of digital systems on processes and outcomes in the care management of acute kidney injury and progress towards establishing learning healthcare systems. BMJ Health Care Inform 2021; 28:e100345. [PMID: 34233898 PMCID: PMC8264899 DOI: 10.1136/bmjhci-2021-100345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/08/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Digital systems have long been used to improve the quality and safety of care when managing acute kidney injury (AKI). The availability of digitised clinical data can also turn organisations and their networks into learning healthcare systems (LHSs) if used across all levels of health and care. This review explores the impact of digital systems i.e. on patients with AKI care, to gauge progress towards establishing LHSs and to identify existing gaps in the research. METHODS Embase, PubMed, MEDLINE, Cochrane, Scopus and Web of Science databases were searched. Studies of real-time or near real-time digital AKI management systems which reported process and outcome measures were included. RESULTS Thematic analysis of 43 studies showed that most interventions used real-time serum creatinine levels to trigger responses to enable risk prediction, early recognition of AKI or harm prevention by individual clinicians (micro level) or specialist teams (meso level). Interventions at system (macro level) were rare. There was limited evidence of change in outcomes. DISCUSSION While the benefits of real-time digital clinical data at micro level for AKI management have been evident for some time, their application at meso and macro levels is emergent therefore limiting progress towards establishing LHSs. Lack of progress is due to digital maturity, system design, human factors and policy levers. CONCLUSION Future approaches need to harness the potential of interoperability, data analytical advances and include multiple stakeholder perspectives to develop effective digital LHSs in order to gain benefits across the system.
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Affiliation(s)
- Clair Ka Tze Chew
- Transformation and Innovation Team, University College London Hospitals NHS Foundation Trust, London, UK
| | - Helen Hogan
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Yogini Jani
- Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, UK
- UCL School of Pharmacy, University College London, London, UK
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Barker J, Smith-Byrne K, Sayers O, Joseph K, Sleeman M, Lasserson D, Vaux E. Electronic alerts for acute kidney injury across primary and secondary care. BMJ Open Qual 2021; 10:e000956. [PMID: 33972363 PMCID: PMC8112408 DOI: 10.1136/bmjoq-2020-000956] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/03/2022] Open
Abstract
PROBLEM In 2009 the National Confidential Enquiry into Patient Outcome and Death suggested only 50% of patients with acute kidney injury (AKI) receive good standards of care. In response National Health Service (NHS) England mandated the use of electronic AKI alerts within secondary care. However, we recognised AKI is not just a secondary care problem, where primary care has a crucial role to play in prevention, early detection and management as well as post-AKI care. METHODS AKI alerts were implemented in primary and secondary care services for a population of 480 000. Comparisons were made in AKI incidence, peak creatinine following AKI and renal recovery in the years before and after using Byar's approximation (95% CI). INTERVENTION A complex quality improvement initiative was implemented based on the design and integration of an AKI alerting system within laboratory information management systems for primary and secondary care, with an affixed URL for clinicians to access a care bundle of AKI guidelines on safe prescribing, patient advice and early contact with nephrology. RESULTS The intervention was associated with an 8% increase in creatinine testing (n=32 563). Hospital acquired AKI detection increased by 6%, while community acquired AKI detection increased by 3% and AKI stage 3 detected in primary care fell by 14%. The intervention overall had no effect on AKI severity but did improve follow-up testing and renal recovery. Importantly hospital AKI 3 recoveries improved by 22%. In a small number of AKI cases, the algorithm did not produce an alert resulting in a reduction in follow-up testing compared with preintervention levels. CONCLUSION The introduction of AKI alerts in primary and secondary care, in conjunction with access to an AKI care bundle, was associated with higher rates of repeat blood sampling, AKI detection and renal recovery. Validating accuracy of alerts is required to avoid patient harm.
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Affiliation(s)
- Joseph Barker
- Oxford University Clinical Academic Graduate School, NIHR Oxford Biomedical Research Centre, Oxford, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Karl Smith-Byrne
- Genomic Epidemiology Branch, Section of Genetics, International Agency for Research on Cancer, Lyon, France
| | | | - Krishan Joseph
- Department of Opthalmology, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Mark Sleeman
- Department of Pathology, Royal Berkshire NHS Foundation Trust, Reading, UK
| | - Daniel Lasserson
- Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Emma Vaux
- Department of Nephrology, Royal Berkshire NHS Foundation Trust, Reading, UK
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Vanholder R, Rondeau E, Anders HJ, Carlson N, Fliser D, Kanbay M, António Lopes J, Murray PT, Ortiz A, Sanz AB, Selby NM, Wiecek A, Massy ZA. EDTAKI: A Nephrology and Public Policy Committee (NPPC) Platform Call for More European Involvement in AKI. Nephrol Dial Transplant 2021; 37:740-748. [PMID: 33527142 DOI: 10.1093/ndt/gfab018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Indexed: 01/08/2023] Open
Abstract
Acute Kidney Injury (AKI) is an often neglected but crucial element of clinical nephrology. The aim of the Nephrology Public Policy Committee (NPPC) of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) is to promote several key aspects of European nephrology. One of the targets proposed by NPPC was to advance European nephrology involvement in AKI. We undertook literature analyses to define the current position of European nephrology in the field of AKI compared to other regions, and about how different European countries compare to each other. It appeared that vis-à-vis countries with a comparable socio-economic status (the US, Australia, New Zealand, Canada), the European contribution was almost 50% lower. Within Europe, Central/Eastern Europe and countries with a lower gross domestic product (GDP) showed lower scientific output. Nephrologists contributed to less than half of the output. There was no trend for a change over the last decade. It is concluded that there is room to improve the contribution of European nephrology in the field of AKI. We propose a model on how to promote clinical collaboration on AKI across Europe, the creation of a pan-European nephrology network of interested units is proposed, to improve clinical outcomes, increase nephrologist involvement and awareness outside nephrology, and stimulate research on AKI in Europe. Accordingly, we also propose a list of research priorities and stress the need for more European funding of AKI research.
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Affiliation(s)
- Raymond Vanholder
- Nephrology Section, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium; European Kidney Health Alliance (EKHA), Brussels, Belgium
| | - Eric Rondeau
- Renal Intensive Care and Transplantation Unit, Hôpital TENON, APHP, Paris; Sorbonne Université, Paris, France
| | - Hans-Joachim Anders
- Division of Nephrology, Department of Medicine IV, University Hospital LMU Munich, Munich, Germany
| | - Nicholas Carlson
- Department of Nephrology, Copenhagen University Hospital Rigshospitalet, Denmark, and Department of Research, The Danish Heart Foundation
| | - Danilo Fliser
- Internal Medicine IV, Saarland University Medical Center, Homburg/Saar, Germany
| | - Mehmet Kanbay
- Nephrology Section, Department of Internal Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - José António Lopes
- Division of Nephrology and Renal Transplantation, Centro Hospitalar Universitário Lisboa Norte, Av. Prof. Egas Moniz, 1649-035, Lisboa, Portugal
| | - Patrick T Murray
- School of Medicine, University College Dublin, UCD Catherine McAuley Education & Research Centre, Eccles Street, Dublin 7, Ireland
| | - Alberto Ortiz
- Research Institute Fundacion Jemenez Diaz, Autonoma University Madrid, Spain
| | - Ana B Sanz
- Research Institute Fundacion Jemenez Diaz, Autonoma University Madrid, Spain
| | - Nicholas M Selby
- Centre for Kidney Research and Innovation, Division of Health Sciences and Graduate Entry Medicine, University of Nottingham, UK
| | - Andrzej Wiecek
- Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia in Katowice, Poland
| | - Ziad A Massy
- Department of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt/Paris, and Centre for Research in Epidemiology and Population Health (CESP), Paris-Saclay University, Versailles Saint Quentin University, INSERM UMRS 1018, Team5 Villejuif, France
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Clinical News. Br J Hosp Med (Lond) 2019; 80:188-191. [DOI: 10.12968/hmed.2019.80.4.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Getting involved with Clinical Medicine. Clin Med (Lond) 2019; 19:97. [PMID: 30872287 PMCID: PMC6454354 DOI: 10.7861/clinmedicine.19-2-97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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