ArticleKidney research and clinical practice2023
Electronic alert outpatient protocol improves the quality of care for the risk of postcontrast acute kidney injury following computed tomography.
Article in Kidney research and clinical practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 4 citations in OpenAlex.
- A Risk Prediction Model (CMC-AKIX) for Postoperative Acute Kidney Injury Using Machine Learning: Algorithm Development and Validation.Journal of medical Internet research · 2025Article
- Artificial intelligence and predictive models for early detection of acute kidney injury: transforming clinical practice.BMC nephrology · 2024Review
- Electronic alerts based on clinical decision support system for post-contrast acute kidney injury.Kidney research and clinical practice · 2023Article
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Authors and funding
9 authors at 3 institutions in 1 country.
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Abstract
backgroundPrevention and diagnosis of postcontrast acute kidney injury (AKI) after contrast-enhanced computed tomography is burdensome in outpatient department. We investigated whether an electronic alert system could improve prevention and diagnosis of postcontrast AKI.
methodsIn March 2018, we launched an electronic alert system that automatically identifies patients with a baseline estimated glomerular filtration rate of <45 mL/min/1.73 m2, provides a prescription of fluid regimen, and recommends a follow-up for serum creatinine measurement. Participants prescribed contrast-enhanced computed tomography at outpatient department before and after the launch of the system were categorized as historical and alert group, respectively. Propensity for the surveillance of postcontrast AKI was compared using logistic regression. Risks of AKI, admission, mortality, and renal replacement therapy were analyzed.
resultsThe historical and alert groups included 289 and 309 participants, respectively. The alert group was more likely to be men and take diuretics. The most frequent volume of prophylactic fluid in historical and alert group was 1,000 and 750 mL, respectively. Follow-up for AKI was more common in the alert group (adjusted odds ratio, 6.00; p < 0.001). Among them, incidence of postcontrast AKI was not statistically different. The two groups did not differ in risks of admission, mortality, or renal replacement therapy.
conclusionThe electronic alert system could assist in the detection of high-risk patients, prevention with reduced fluid volume, and proper diagnosis of postcontrast AKI, while limiting the prescribing clinicians' burden. Whether the system can improve long-term outcomes remains unclear.
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