Sp244renal Dysfunction in Hospital Patients. Utility of an Electronic Alert System. Detect-H Proyect

Abstract

Introduction and Aims: Renal dysfunction is an important factor in hospitalized patients' management. The aim of our study was to analyse the prevalence of chronic kidney disease and acute kidney injury in our hospital, length of stay and in-hospital mortality. Methods: Our hospital provides services for 192.290 residents and specialist services to 404.517 from neighbouring areas, with 520 inpatients beds. To improve renal dysfunction detection rates we developed a fully automated, electronic alert system which identifies all cases of reduced glomerular filtration rate according to CKD-EPI formula in patients over 14 years. We established to levels of alert, less than 60 mL/min/1.73m2 and less than 30 mL/min/1.73m2 in patients over 80, based on our national nephrology referral guidelines. Patients admitted to our nephrology department and on dialysis were excluded. Detected patients were studied. Chronic kidney disease (CKD) and acute kidney injury (AKI) was defined according to KDIGO guidelines. Baseline serum creatinine was the lowest level between 0.5-6 months before admission. Length of stay and in-hospital mortality was recorded. Results: Between January and June 2014, 11.022 completed adult patient admission episodes occurred. The number of alerts issued was 1.241 (11.3% of admissions),