SynthesisCritical care (London, England)2025
The influence of electronic AKI alert on prognosis of adult hospitalized patients: a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk prediction models for acute kidney injury in patients with acute pancreatitis: a systematic review.BMC gastroenterology · 2026Pooled it
- Artificial Intelligence in Critical Care Nephrology: Current Applications, Emerging Techniques, and Challenges to Clinical Integration.Kidney360 · 2026Review
- From haemodynamics to kidney risk: AI-based early prediction validated in general and burn ICU populations.European heart journal. Digital health · 2026Article
- Application of continuous renal replacement therapy (CRRT) in patients with severe acute pancreatitis: an analytical study.BMC gastroenterology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundAcute kidney injury (AKI) is a critical yet frequently under diagnosed condition in hospitalized patients, impacting morbidity and mortality. Electronic alerts for AKI aimed to assist physicians in early diagnosis and intervention, though evidence for their effectiveness is inconsistent. MATERIALS AND
methodsA systematic search was conducted in PubMed, the Cochrane Central Register of Controlled Trials, Cochrane Library, and Web of Science from inception to November 2024. Eligible studies included randomized controlled trials (RCTs), before-and-after analyses, and stepped-wedge designs involving hospitalized patients. The primary outcomes were mortality and renal replacement therapy (RRT) rates, Secondary outcomes included hospital length of stay (LoS), AKI progression and recovery. Care-centered outcomes encompassed nephrologist consultation, nephrotoxic medication discontinuation and medication review. Subgroup analysis examined the impact of response intensity, hospital type and geographic region on these outcomes.
resultsTwenty-two studies involving 170,696 participants were included: 8 RCTs (n = 21,710) and 14 non-RCTs or observational studies (n = 148,986). RCTs showed no effect on mortality (RR 1.02; 95% CI 0.97-1.07) or LoS (mean difference 0.04; 95% CI - 0.13 to 0.22) but a significant increase in RRT use (RR 1.13; 95% CI 1.02-1.26) with AKI alert systems. Non-RCTs, however, reported reduced mortality (RR 0.92; 95% CI 0.88-0.96), less AKI progression (RR 0.85; 95% CI 0.77-0.94), enhanced kidney recovery (RR 1.65; 95% CI 1.56-1.75), increased nephrotoxic drug discontinuation (RR 1.20; 95% CI 1.13-1.28), and higher drug review rates (RR 1.19; 95% CI 1.17-1.21), with no impact on RRT use (RR 1.08; 95% CI 0.87-1.36). Subgroup analysis revealed an increased in-hospital mortality in low response intensity (RR 1.15; 95% CI 1.00-1.32), reduced mortality in moderate response intensity (RR 0.93; 95% CI 0.89-0.97), and unclear effects in high response intensity (RR 0.88; 95% CI 0.70-1.09). AKI alert was also favored in teaching hospitals and in several regions (Europe, North America and South America).
conclusionThe efficacy of AKI alerts remains inconclusive. Current evidence do not support or refute their effectiveness. Variability in response intensity, hospital type and geographic region may help explaining discrepancies, underscoring the need for further research to optimize AKI alert systems with more effective action in clinical practice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.