ArticleBMJ quality & safety2012
How do centres begin the process to prevent contrast-induced acute kidney injury: a report from a new regional collaborative.
Article in BMJ quality & safety, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Baseline atrial fibrillation is associated with contrast-induced nephropathy after cardiac catheterization in coronary artery disease: Systemic review and meta-analysis.Clinical cardiology · 2018Pooled it
- Sustained Improvements After Intervention to Prevent Contrast-Associated Acute Kidney Injury: A Randomized Controlled Trial.Journal of the American Heart Association · 2025Trial
- Trial
- Cost-Effectiveness of Team-Based Coaching With Surveillance for Prevention of Acute Kidney Injuries.JAMA network open · 2025Article
- Implementation Science in Acute Kidney Injury Care: Challenges and Opportunities.Advances in kidney disease and health · 2025Review
- Factors Shaping the Implementation of Strategies to Prevent Acute Kidney Injury: A Qualitative Study.Qualitative health research · 2024Article
- Change Management Accompanying Implementation of Decision Support for Prevention of Acute Kidney Injury in Cardiac Catheterization Units: Program Report.Canadian journal of kidney health and disease · 2023Article
- Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention.Open heart · 2022Article
- Maintaining a National Acute Kidney Injury Risk Prediction Model to Support Local Quality Benchmarking.Circulation. Cardiovascular quality and outcomes · 2022Article
- Article
- Patient Experience After Risk Stratification and Follow-up for Acute Kidney Injury After Cardiac Catheterization: Patient Survey.CJC open · 2021Article
- Refining Safe Contrast Limits for Preventing Acute Kidney Injury After Percutaneous Coronary Intervention.Journal of the American Heart Association · 2021Article
- Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety.Critical care nurse · 2017Article
- Chronic Kidney Disease Progression and Cardiovascular Outcomes Following Cardiac Catheterization-A Population-Controlled Study.Journal of the American Heart Association · 2016Article
- Incidence and In-Hospital Mortality of Acute Kidney Injury (AKI) and Dialysis-Requiring AKI (AKI-D) After Cardiac Catheterization in the National Inpatient Sample.Journal of the American Heart Association · 2016Article
- Acute Kidney Injury Risk Prediction in Patients Undergoing Coronary Angiography in a National Veterans Health Administration Cohort With External Validation.Journal of the American Heart Association · 2015Article
- Contrast Medium-Induced Acute Kidney Injury.Cardiorenal medicine · 2015Review
- A modified Delphi process to identify process of care indicators for the identification, prevention and management of acute kidney injury after major surgery.Canadian journal of kidney health and disease · 2015Article
- Reducing contrast-induced acute kidney injury using a regional multicenter quality improvement intervention.Circulation. Cardiovascular quality and outcomes · 2014Article
- Contemporary incidence, predictors, and outcomes of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the NCDR Cath-PCI registry.JACC. Cardiovascular interventions · 2014Article
Corrections and comments
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Authors and funding
19 authors at 12 institutions in 1 country.
Funding
Abstract
objectivesThis study evaluates the variation in practice patterns associated with contrast-induced acute kidney injury (CI-AKI) and identifies clinical practices that have been associated with a reduction in CI-AKI. Background CI-AKI is recognised as a complication of invasive cardiovascular procedures and is associated with cardiovascular events, prolonged hospitalisation, end-stage renal disease, and all-cause mortality. Reducing the risk of CI-AKI is a patient safety objective set by the National Quality Forum.
methodsThis study prospectively collected quantitative and qualitative data from 10 centres, which participate in the Northern New England Cardiovascular Disease Study Group PCI Registry. Quantitative data were collected from the PCI Registry. Qualitative data were obtained through clinical team meetings to map care processes related to CI-AKI and focus groups to understand attitudes towards CI-AKI prophylaxis. Fixed and random effects modelling were conducted to test the differences across centres.
resultsSignificant variation in rates of CI-AKI were found across 10 medical centres. Both fixed effects and mixed effects logistic regression demonstrated significant variability across centres, even after adjustment for baseline covariates (p<0.001 for both modelling approaches). Patterns were found in reported processes and clinical leadership that were attributable to centres with lower rates of CI-AKI. These included reducing nil by mouth (NPO) time to 4 h prior to case, and standardising volume administration protocols in combination with administering three to four high doses of N-acetylcysteine (1200 mg) for each patient.
conclusionsThese data suggest that clinical leadership and institution-focused efforts to standardise preventive practices can help reduce the incidence of CI-AKI.
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Registered trials
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