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2015 | OriginalPaper | Buchkapitel

10. Alternative Auslöser eines „AKI-Alarms“

verfasst von: Michael Haase, Anja Haase-Fielitz

Erschienen in: Akute Nierenschädigung

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Zukünftige Alarmsysteme zur Früherkennung der akuten Nierenschädigung basieren nicht nur auf einem Kreatinin-Anstieg, sondern berücksichtigen auch einen akuten Kreatinin-Abfall, um auch Patienten mit einer stattgehabten akuten Nierenschädigung zu identifizieren und einer ambulanten Nachsorge zuzuführen. Auch Kreatinin-unabhängige Auslöser wie ein Diurese-Rückgang können geeignet sein, einen AKI-Alarm auszulösen und somit die Frühdiagnose zu ermöglichen. Zu weiteren Kreatinin-unabhängigen AKI-Alarm-Auslösern können zählen: Cystatin-C-Anstieg, Tubulusmarker-Positivität, nephrotoxische Medikamente und die Zunahme einer Albuminurie. Auch wenn die Anforderungen der Programmierung von Algorithmen solcher Alarmauslöser an die IT und die beteiligten Ärzte deutlich höher sind als sie bei Programmierung und Aufrechterhaltung eines Kreatinin-Anstieg basierten Alarmsystems auftreten, komplettieren Kreatinin-Anstieg unabhängige Auslöser die integrierte Versorgung von Patienten mit akuter Nierenschädigung.
Literatur
Zurück zum Zitat Bouchard J, Soroko SB, Chertow GM, Himmelfarb J, Ikizler TA, Paganini EP, Mehta RL; Program to Improve Care in Acute Renal Disease (PICARD) Study Group. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int. 2009;76:422–7 CrossRefPubMed Bouchard J, Soroko SB, Chertow GM, Himmelfarb J, Ikizler TA, Paganini EP, Mehta RL; Program to Improve Care in Acute Renal Disease (PICARD) Study Group. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int. 2009;76:422–7 CrossRefPubMed
Zurück zum Zitat Calzavacca P, Tee A, Licari E, Schneider AG, Bellomo R. Point-of-care measurement of serum creatinine in the intensive care unit. Ren Fail. 2012;34:13–8 CrossRefPubMed Calzavacca P, Tee A, Licari E, Schneider AG, Bellomo R. Point-of-care measurement of serum creatinine in the intensive care unit. Ren Fail. 2012;34:13–8 CrossRefPubMed
Zurück zum Zitat Clinical Trials Network, Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, deBoisblanc B, Connors AF Jr, Hite RD, Harabin AL, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS). Comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006;354:2564–75 CrossRef Clinical Trials Network, Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, deBoisblanc B, Connors AF Jr, Hite RD, Harabin AL, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS). Comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006;354:2564–75 CrossRef
Zurück zum Zitat Coca SG, Garg AX, Thiessen-Philbrook H, Koyner JL, Patel UD, Krumholz HM, Shlipak mg, Parikh CR; TRIBE-AKI Consortium. Urinary biomarkers of AKI and mortality 3 years after cardiac surgery. J Am Soc Nephrol. 2014;25:1063–71 CrossRefPubMedCentralPubMed Coca SG, Garg AX, Thiessen-Philbrook H, Koyner JL, Patel UD, Krumholz HM, Shlipak mg, Parikh CR; TRIBE-AKI Consortium. Urinary biomarkers of AKI and mortality 3 years after cardiac surgery. J Am Soc Nephrol. 2014;25:1063–71 CrossRefPubMedCentralPubMed
Zurück zum Zitat Colpaert K, Hoste EA, Steurbaut K, Benoit D, Van Hoecke S, De Turck F, Decruyenaere J. Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class. Crit Care Med. 2012;40:1164–70 CrossRefPubMed Colpaert K, Hoste EA, Steurbaut K, Benoit D, Van Hoecke S, De Turck F, Decruyenaere J. Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class. Crit Care Med. 2012;40:1164–70 CrossRefPubMed
Zurück zum Zitat KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2012 doi:10.1038/kisup.2012 KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2012 doi:10.1038/kisup.2012
Zurück zum Zitat Haase M, Bellomo R, Devarajan P, Schlattmann P, Haase-Fielitz A; NGAL Meta-analysis Investigator Group. Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis. 2009;54:1012–24 CrossRefPubMed Haase M, Bellomo R, Devarajan P, Schlattmann P, Haase-Fielitz A; NGAL Meta-analysis Investigator Group. Accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in diagnosis and prognosis in acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis. 2009;54:1012–24 CrossRefPubMed
Zurück zum Zitat Handler SM, Cheung PW, Culley CM, Perera S, Kane-Gill SL, Kellum JA, Marcum ZA. Determining the incidence of drug-associated acute kidney injury in nursing home residents. J Am Med Dir Assoc. 2014;15:719–24 CrossRefPubMed Handler SM, Cheung PW, Culley CM, Perera S, Kane-Gill SL, Kellum JA, Marcum ZA. Determining the incidence of drug-associated acute kidney injury in nursing home residents. J Am Med Dir Assoc. 2014;15:719–24 CrossRefPubMed
Zurück zum Zitat Heung M, Wolfgram DF, Kommareddi M, Hu Y, Song PX, Ojo AO. Fluid overload at initiation of renal replacement therapy is associated with lack of renal recovery in patients with acute kidney injury. Nephrol Dial Transplant. 2012;27:956–61 CrossRefPubMedCentralPubMed Heung M, Wolfgram DF, Kommareddi M, Hu Y, Song PX, Ojo AO. Fluid overload at initiation of renal replacement therapy is associated with lack of renal recovery in patients with acute kidney injury. Nephrol Dial Transplant. 2012;27:956–61 CrossRefPubMedCentralPubMed
Zurück zum Zitat Hoste EA, McCullough PA, Kashani K, Chawla LS, Joannidis M, Shaw AD, Feldkamp T, Uettwiller-Geiger DL, McCarthy P, Shi J, Walker MG, Kellum JA; Sapphire Investigators. Derivation and validation of cutoffs for clinical use of cell cycle arrest biomarkers. Nephrol Dial Transplant. 2014;29:2054–61 CrossRefPubMedCentralPubMed Hoste EA, McCullough PA, Kashani K, Chawla LS, Joannidis M, Shaw AD, Feldkamp T, Uettwiller-Geiger DL, McCarthy P, Shi J, Walker MG, Kellum JA; Sapphire Investigators. Derivation and validation of cutoffs for clinical use of cell cycle arrest biomarkers. Nephrol Dial Transplant. 2014;29:2054–61 CrossRefPubMedCentralPubMed
Zurück zum Zitat Macedo E, Malhotra R, Bouchard J, Wynn SK, Mehta RL. Oliguria is an early predictor of higher mortality in critically ill patients. Kidney Int. 2011;80:760–7 CrossRefPubMed Macedo E, Malhotra R, Bouchard J, Wynn SK, Mehta RL. Oliguria is an early predictor of higher mortality in critically ill patients. Kidney Int. 2011;80:760–7 CrossRefPubMed
Zurück zum Zitat Mathew G, Kho A, Dexter P, Bloodworth N, Fantz C, Spell N, LaBorde DV. Concept and development of a discharge alert filter for abnormal laboratory values coupled with computerized provider order entry: a tool for quality improvement and hospital risk management. J Patient Saf. 2012;8:69–75 CrossRefPubMed Mathew G, Kho A, Dexter P, Bloodworth N, Fantz C, Spell N, LaBorde DV. Concept and development of a discharge alert filter for abnormal laboratory values coupled with computerized provider order entry: a tool for quality improvement and hospital risk management. J Patient Saf. 2012;8:69–75 CrossRefPubMed
Zurück zum Zitat McCoy AB, Waitman LR, Gadd CS, Danciu I, Smith JP, Lewis JB, Schildcrout JS, Peterson JF. A computerized provider order entry intervention for medication safety during acute kidney injury: a quality improvement report. Am J Kidney Dis. 2010 Nov;56(5):832–41 CrossRefPubMedCentralPubMed McCoy AB, Waitman LR, Gadd CS, Danciu I, Smith JP, Lewis JB, Schildcrout JS, Peterson JF. A computerized provider order entry intervention for medication safety during acute kidney injury: a quality improvement report. Am J Kidney Dis. 2010 Nov;56(5):832–41 CrossRefPubMedCentralPubMed
Zurück zum Zitat Menachem I, Ami M, Barlavie Y. Electronic urine output monitoring – a novel approach for patient care improvement. Connect: The World of Critical Care Nursing 2008, connectpublishing.org/assets/journals/6_4_4.pdf Menachem I, Ami M, Barlavie Y. Electronic urine output monitoring – a novel approach for patient care improvement. Connect: The World of Critical Care Nursing 2008, connectpublishing.org/assets/journals/6_4_4.pdf
Zurück zum Zitat Molnar AO, Parikh CR, Sint K, Coca SG, Koyner J, Patel UD, Butrymowicz I, Shlipak M, Garg AX. Association of postoperative proteinuria with AKI after cardiac surgery among patients at high risk. Clin J Am Soc Nephrol. 2012;7:1749–60 CrossRefPubMedCentralPubMed Molnar AO, Parikh CR, Sint K, Coca SG, Koyner J, Patel UD, Butrymowicz I, Shlipak M, Garg AX. Association of postoperative proteinuria with AKI after cardiac surgery among patients at high risk. Clin J Am Soc Nephrol. 2012;7:1749–60 CrossRefPubMedCentralPubMed
Zurück zum Zitat Nickolas TL, O'Rourke MJ, Yang J, Sise ME, Canetta PA, Barasch N, Buchen C, Khan F, Mori K, Giglio J, Devarajan P, Barasch J. Sensitivity and specificity of a single emergency department measurement of urinary neutrophil gelatinase-associated lipocalin for diagnosing acute kidney injury. Ann Intern Med. 2008;148:810–9 CrossRefPubMedCentralPubMed Nickolas TL, O'Rourke MJ, Yang J, Sise ME, Canetta PA, Barasch N, Buchen C, Khan F, Mori K, Giglio J, Devarajan P, Barasch J. Sensitivity and specificity of a single emergency department measurement of urinary neutrophil gelatinase-associated lipocalin for diagnosing acute kidney injury. Ann Intern Med. 2008;148:810–9 CrossRefPubMedCentralPubMed
Zurück zum Zitat Prowle JR, Liu YL, Licari E, Bagshaw SM, Egi M, Haase M, Haase-Fielitz A, Kellum JA, Cruz D, Ronco C, Tsutsui K, Uchino S, Bellomo R. Oliguria as predictive biomarker of acute kidney injury in critically ill patients. Crit Care. 2011;15:R172 CrossRefPubMedCentralPubMed Prowle JR, Liu YL, Licari E, Bagshaw SM, Egi M, Haase M, Haase-Fielitz A, Kellum JA, Cruz D, Ronco C, Tsutsui K, Uchino S, Bellomo R. Oliguria as predictive biomarker of acute kidney injury in critically ill patients. Crit Care. 2011;15:R172 CrossRefPubMedCentralPubMed
Zurück zum Zitat Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C; Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294:813–8 CrossRefPubMed Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C; Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294:813–8 CrossRefPubMed
Zurück zum Zitat Udy A, O'Donoghue S, D'Intini V, Healy H, Lipman J. Point of care measurement of plasma creatinine in critically ill patients with acute kidney injury. Anaesthesia. 2009;64:403–7 CrossRefPubMed Udy A, O'Donoghue S, D'Intini V, Healy H, Lipman J. Point of care measurement of plasma creatinine in critically ill patients with acute kidney injury. Anaesthesia. 2009;64:403–7 CrossRefPubMed
Zurück zum Zitat Waitman LR, Phillips IE, McCoy AB, Danciu I, Halpenny RM, Nelsen CL, Johnson DC, Starmer JM, Peterson JF. Adopting real-time surveillance dashboards as a component of an enterprisewide medication safety strategy. Jt Comm J Qual Patient Saf. 2011;37:326–32 PubMed Waitman LR, Phillips IE, McCoy AB, Danciu I, Halpenny RM, Nelsen CL, Johnson DC, Starmer JM, Peterson JF. Adopting real-time surveillance dashboards as a component of an enterprisewide medication safety strategy. Jt Comm J Qual Patient Saf. 2011;37:326–32 PubMed
Metadaten
Titel
Alternative Auslöser eines „AKI-Alarms“
verfasst von
Michael Haase
Anja Haase-Fielitz
Copyright-Jahr
2015
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-642-45080-8_10

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