Evidence map›Paper›PMID 42891121›Full record

ArticleAnnals of intensive care2026

National variation in acute kidney injury diagnosis and monitoring across adult intensive care units in china: a nationwide cross-sectional survey.

Xinran Wang, Xiuhua Zhang, Weiting Zhang, Yu Xin, Pengfei Huang, Yanqi Liu, Kai Zeng, Xianglin Meng, Zhiyong Peng, Wenxiong Li and 6 more

Abstract read
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In one paragraph

Article in Annals of intensive care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

16 authors.

Xinran WangDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.
Xiuhua ZhangDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.
Weiting ZhangDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.
Yu XinDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.
Pengfei HuangDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.
Yanqi LiuDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.
Kai ZengDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.
Xianglin MengDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.
Zhiyong PengDepartment of Critical Care Medicine, Zhongnan Hospital of Wuhan University, No. 169 East Lake Road, Wuchang District, Wuhan 430071, Hubei Province, China.
Wenxiong LiDepartment of Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing 100020, China.
Zhenjie HuDepartment of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Shijiazhuang 050011, Hebei Province, China.
Yingzi HuangJiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, No. 87 Dingjiaqiao Road, Gulou District, Nanjing 210009, Jiangsu Province, China.
Meili DuanDepartment of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing 100050, China.
Mingyan ZhaoDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.
Kaijiang YuDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.
Changsong WangDepartment of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, No. 23 You Zheng Street, Harbin 150001, Heilongjiang Province, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Acute kidney injury (AKI) is common in critically ill patients and strongly associated with adverse outcomes, yet national ICU-level evidence on AKI diagnosis and monitoring in China remains limited. Methods: We conducted a nationwide anonymous cross-sectional web survey of adult ICUs in China from June 25 to September 26, 2025. The survey assessed AKI diagnosis and staging, UO and SCr monitoring across clinical scenarios, biomarker use, early warning systems, and changes in UO monitoring after AKI. We used multivariable logistic regression to identify factors associated with UO-monitoring practices, with FDR correction for multiple comparisons. An exploratory 0-100-point AKI-MIS summarised ICU-level monitoring implementation, with higher scores indicating broader implementation. Results: Of 2,002 responses, 1,896 unique adult ICU units were included. AKI diagnosis was reported by 97.9% of ICUs, whereas 63.2% explicitly implemented staging and 75.9% used both UO and SCr for diagnosis. Hourly UO monitoring increased from 49.6% in routine practice to 74.1% in sepsis, 75.0% in AKI, and 77.7% in sepsis-associated AKI. Dynamic UO monitoring was implemented in 14.8% of ICUs; 83.5% reported increased nursing workload, and 69.9% identified workload or insufficient staffing as the main barrier. After FDR correction, geographic region, nurse-to-bed ratio, and baseline monitoring intensity were associated with UO-monitoring practices. The median AKI-MIS was 68.1 (IQR, 60.3-74.9), with higher adjusted scores in teaching hospitals. Conclusions: Among participating adult ICU units across all 31 provincial-level administrative regions of mainland China, AKI diagnosis and monitoring were widely reported, but substantial heterogeneity remained across monitoring systems. These findings provide a broad descriptive benchmark and identify priorities for strengthening standardisation, risk-responsive escalation, and closed-loop response pathways.

Indexed as

Acute kidney injuryChinaCritical careIntensive care unitsQuality improvementserum creatinineUrine output monitoring

Identifiers

PMID42891121
PMCPMC13673355

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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.