TY - JOUR
T1 - Aki!now initiative
T2 - Recommendations for awareness, recognition, and management of aki
AU - AKI!Now Initiative of the American Society of Nephrology
AU - Liu, Kathleen D.
AU - Goldstein, Stuart L.
AU - Vijayan, Anitha
AU - Parikh, Chirag R.
AU - Kashani, Kianoush
AU - Okusa, Mark D.
AU - Agarwal, Anupam
AU - Cerdá, Jorge
N1 - Funding Information:
A. Agarwal is President of ASN and a member of the Steering Committee for AKI!Now. A. Agarwal reports receiving grants from Baxter, during the conduct of the study; personal fees from Akebia Therapeutics and Angion; personal fees and other from Goldilocks Therapeutics, Inc.; and personal fees from Dynamed and Reata Pharmaceuticals; outside the submitted work. S.L. Goldstein reports receiving personal fees from Baxter Healthcare, BioPorto Inc., CHF Solutions, Fresenius, MediBeacon, and Medtronic, outside the submitted work. K.D. Liu reports receiving personal fees from Bi-omerieux, Durect, Potrero Med, Quark, Theravance, and UpToDate; and other from the American Thoracic Society, Amgen, As-traZeneca, Baxter, and the National Policy Forum on Critical Care and Acute Renal Failure; outside the submitted work. M.D. Okusa reports receiving personal fees from UpToDate, outside the submitted work. C.R. Parikh reports receiving grants from the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute; and other from Akebia Therapeutics, Inc., Genfit Biopharmaceutical Company, and Re-naltix AI; outside the submitted work. A. Vijayan is a speaker for Sanofi-Aventis and a consultant for NxStage and Boerhinger-Ingelheim. All remaining authors have nothing to disclose.
Publisher Copyright:
© 2020 by the American Society of Nephrology.
PY - 2020/12/7
Y1 - 2020/12/7
N2 - The American Society of Nephrology has established a new initiative, AKI!Now, with the goal of promoting excellence in the prevention and treatment of AKI by building a foundational program that transforms education and delivery of AKI care, aiming to reduce morbidity and associated mortality and to improve long-term outcomes. In this article, we describe our current efforts to improve early recognition and management involving inclusive interdisciplinary collaboration between providers, patients, and their families; discuss the ongoing need to change some of our current AKI paradigms and diagnostic methods; and provide specific recommendations to improve AKI recognition and care. In the hospital and the community, AKI is a common and increasingly frequent condition that generates risks of adverse events and high costs. Unfortunately, patients with AKI may frequently have received less than optimal quality of care. New classifications have facilitated understanding of AKI incidence and its impact on outcomes, but they are not always well aligned with AKI pathophysiology. Despite ongoing research efforts, treatments to promote or hasten kidney recovery remain ineffective. To avoid progression, the current approach to AKI emphasizes the promotion of early recognition and timely response. However, a lack of awareness of the importance of early recognition and treatment among health care team members and the heterogeneity of approaches within the health care teams assessing the patient remains a major challenge. Early identification is further complicated by differences in settings where AKI occurs (the community or the hospital), and by differences in patient populations and cultures between the intensive care unit and ward environments. To address these obstacles, we discuss the need to improve education at all levels of care and to generate specific guidance on AKI evaluation and management, including the development of a widely applicable education and an AKI management toolkit, engaging hospital administrators to incorporate AKI as a quality initiative, and raising awareness of AKI as a complication of other disease processes.
AB - The American Society of Nephrology has established a new initiative, AKI!Now, with the goal of promoting excellence in the prevention and treatment of AKI by building a foundational program that transforms education and delivery of AKI care, aiming to reduce morbidity and associated mortality and to improve long-term outcomes. In this article, we describe our current efforts to improve early recognition and management involving inclusive interdisciplinary collaboration between providers, patients, and their families; discuss the ongoing need to change some of our current AKI paradigms and diagnostic methods; and provide specific recommendations to improve AKI recognition and care. In the hospital and the community, AKI is a common and increasingly frequent condition that generates risks of adverse events and high costs. Unfortunately, patients with AKI may frequently have received less than optimal quality of care. New classifications have facilitated understanding of AKI incidence and its impact on outcomes, but they are not always well aligned with AKI pathophysiology. Despite ongoing research efforts, treatments to promote or hasten kidney recovery remain ineffective. To avoid progression, the current approach to AKI emphasizes the promotion of early recognition and timely response. However, a lack of awareness of the importance of early recognition and treatment among health care team members and the heterogeneity of approaches within the health care teams assessing the patient remains a major challenge. Early identification is further complicated by differences in settings where AKI occurs (the community or the hospital), and by differences in patient populations and cultures between the intensive care unit and ward environments. To address these obstacles, we discuss the need to improve education at all levels of care and to generate specific guidance on AKI evaluation and management, including the development of a widely applicable education and an AKI management toolkit, engaging hospital administrators to incorporate AKI as a quality initiative, and raising awareness of AKI as a complication of other disease processes.
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U2 - 10.2215/CJN.15611219
DO - 10.2215/CJN.15611219
M3 - Review article
C2 - 32317329
AN - SCOPUS:85093680506
SN - 1555-9041
VL - 15
SP - 1838
EP - 1847
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 12
ER -