Impact of AKI care bundles on kidney and patient outcomes in hospitalized patients: a systematic review and meta-analysis

Schaubroeck, Hannah; Vargas, Diana Carolina; Vandenberghe, Wim; Hoste, Eric A. J.

doi:10.1186/s12882-021-02534-4

Cited by 15 publications

(13 citation statements)

References 44 publications

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“…Limited systematic studies have been conducted to evaluate the effectiveness of AKI care bundles; prior our study, only Schaubroeck et al [ 42 ] presented a comprehensive review and meta-analysis on patient outcomes associated with AKI care bundle implementation. In particular, we extensively searched Chinese databases in order to include similar studies that could potentially serve as professional guidelines for Chinese hospitals.…”

Section: Discussionmentioning

confidence: 99%

Effect of care bundles for acute kidney injury: A systematic review and meta-analysis

Zhang,

Chen,

Zhou

et al. 2024

PLoS ONE

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Purpose Acute kidney injury (AKI) is frequent among in-hospital patients with high incidence and mortality. Implementing a series of evidence-based AKI care bundles may improve patient outcomes by reducing changeable standards of care. The aim of this meta-analysis was therefore to appraise the influences of AKI care bundles on patient outcomes. Materials and methods We explored three international databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) and two Chinese databases (Wanfang Data and China National Knowledge Infrastructure) for studies from databases inception until November 30, 2022, comparing the impact of different AKI care bundles with usual standards of care in patients with or at risk for AKI. The study quality of non-randomized controlled trials and randomized controlled trials was evaluated by the NIH Study Quality Assessment Tool and the Cochrane risk of bias tool. Heterogeneity between studies was appraised by Cochran’s Q test and I2 statistics. The possible origins of heterogeneity between studies were assessed adopting Meta-regression and subgroup analyses. Funnel plot asymmetry and Egger regression and Begg correlation tests were performed to discover potential publication bias. Data analysis was completed by software (RevMan 5.3 and Stata 15.0). The primary outcome was short- or long-term mortality. The secondary outcomes involved the incidence and severity of AKI. Results Sixteen studies containing 25,690 patients and 25,903 AKI episodes were included. In high-risk AKI patients determined by novel biomarkers, electronic alert or risk prediction score, the application of AKI care bundles significantly reduced the AKI incidence (OR, 0.71; 95% CI, 0.53–0.96; p = 0.02; I2 = 84%) and AKI severity (OR, 0.59; 95% CI, 0.39–0.89; p = 0.01; I2 = 65%). No strong evidence is available to prove that care bundles can significantly reduce mortality (OR, 1.16; 95% CI, 0.58–2.30; p = 0.68; I2 = 97%). Conclusions The introduction of AKI care bundles in routine clinical practice can effectively improve the outcomes of patients with or at-risk of AKI. However, the accumulated evidence is limited and not strong enough to make definite conclusions.

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Section: Discussionmentioning

confidence: 99%

Effect of care bundles for acute kidney injury: A systematic review and meta-analysis

Zhang,

Chen,

Zhou

et al. 2024

PLoS ONE

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“…MI type NSTEMI 184 (22) 214 (20) 315 (21) 258 (23) 62 (25) 54 (18) 78 ( 19 482 (32) 264 ( 24) 66 ( 27)…”

Section: Discussionunclassified

Section: Discussionmentioning

confidence: 99%

“…Similar to the IMPROVE AKI trial findings, the systematic review and meta-analysis by Schaubroeck and colleagues 2021 found that when AKI bundles were implemented into routine clinical practice, they were associated with reductions in moderate-to-severe AKI. 32 The closest study to the IMPROVE AKI trial, in scope and execution, was the large northern New England pilot study that empirically developed and evaluated the AKI Prevention Toolkit in a non-VA multisite setting. Contrastassociated AKI prevention strategies resulted in a reduction of relative risk of AKI by 21% for all patients and by 28% in patients with CKD.…”

Section: Discussionmentioning

confidence: 99%

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Team-Based Coaching Intervention to Improve Contrast-Associated Acute Kidney Injury

Brown

Solomon

Stabler

et al. 2023

CJASN

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“…A recent systematic review and meta-analysis [92] suggests that implementation of AKI care bundles in hospitalized patients reduces moderate to severe AKI, but that the overall compliance to AKI care bundles is highly variable.…”

Section: Novel Biomarkers and Their Possible Impact On Definition And...mentioning

confidence: 99%

Reflections on the KDIGO Definition of Acute Kidney Injury and Its Integration in the Concept of Acute Diseases and Disorders and Chronic Kidney Diseases

Lameire

2022

Kidney and Dialysis

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Acute kidney injury (AKI) describes a heterogeneous group of conditions, without specification of their etiology and diagnosed only by indirect markers of glomerular filtration rate (GFR), such as serum creatinine and urine output. Bedside estimation of GFR and detection of structural alterations with novel biomarkers, and stress tests have more recently been developed. These novel findings should probably be included in future AKI definitions. Chronic kidney disease (CKD) is defined by abnormalities in kidney function and structure that persist over >3 months and is classified according to cause, GFR, and albuminuria. Acute kidney disease (AKD) is the term representing patients with abnormalities of function and structure with a duration of ≤3 months that fall outside the definitions of AKI or CKD. Since AKI is by definition also AKD, 2 types of AKD have been proposed, one with and one without AKI. AKD without AKI is common, often undetected, occurs frequently in the outpatient population and shows increased risk of CKD, ESKD and mortality. Alternatively, AKD has also been defined as the period of incomplete recovery following an AKI episode, the latter limited for the duration of 7 days. This contribution discusses the pros and cons of the existence of these 2 definitions of AKD.

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Impact of AKI care bundles on kidney and patient outcomes in hospitalized patients: a systematic review and meta-analysis

Cited by 15 publications

References 44 publications

Effect of care bundles for acute kidney injury: A systematic review and meta-analysis

Effect of care bundles for acute kidney injury: A systematic review and meta-analysis

Team-Based Coaching Intervention to Improve Contrast-Associated Acute Kidney Injury

Reflections on the KDIGO Definition of Acute Kidney Injury and Its Integration in the Concept of Acute Diseases and Disorders and Chronic Kidney Diseases

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