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AKI!Now Initiative: Recommendations for Awareness, Recognition, and Management of AKI

Kathleen D. Liu, Stuart L. Goldstein, Anitha Vijayan, Chirag R. Parikh, Kianoush Kashani, Mark D. Okusa, Anupam Agarwal, Jorge Cerdá and on behalf of the AKI!Now Initiative of the American Society of Nephrology
CJASN December 2020, 15 (12) 1838-1847; DOI: https://doi.org/10.2215/CJN.15611219
Kathleen D. Liu
1University of California at San Francisco School of Medicine, University of California San Francisco, San Francisco, California
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Stuart L. Goldstein
2Center for Acute Nephrology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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Anitha Vijayan
3Division of Nephrology, Washington University in St. Louis, St. Louis, Missouri
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Chirag R. Parikh
4Division of Nephrology, Johns Hopkins University, Baltimore, Maryland
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Kianoush Kashani
5Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota
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Mark D. Okusa
6Division of Nephrology, University of Virginia, Charlottesville, Virginia
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Anupam Agarwal
7Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama
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Jorge Cerdá
8St. Peter’s Health Partners, Albany, New York
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Abstract

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.

  • acute kidney injury
  • critical care nephrology
  • AKI recognition
  • AKI awareness
  • AKI biomarkers
  • artificial intelligence
  • electronic alerts
  • AKI multidisciplinary management
  • AKI urinalysis
  • AKI pathology
  • incidence
  • goals
  • morbidity
  • kidney
  • hospital administrators
  • patient care team
  • quality of health care
  • intensive care units
  • longitudinal studies
  • Copyright © 2020 by the American Society of Nephrology
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Clinical Journal of the American Society of Nephrology: 15 (12)
Clinical Journal of the American Society of Nephrology
Vol. 15, Issue 12
December 07, 2020
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AKI!Now Initiative: Recommendations for Awareness, Recognition, and Management of AKI
Kathleen D. Liu, Stuart L. Goldstein, Anitha Vijayan, Chirag R. Parikh, Kianoush Kashani, Mark D. Okusa, Anupam Agarwal, Jorge Cerdá, on behalf of the AKI!Now Initiative of the American Society of Nephrology
CJASN Dec 2020, 15 (12) 1838-1847; DOI: 10.2215/CJN.15611219

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AKI!Now Initiative: Recommendations for Awareness, Recognition, and Management of AKI
Kathleen D. Liu, Stuart L. Goldstein, Anitha Vijayan, Chirag R. Parikh, Kianoush Kashani, Mark D. Okusa, Anupam Agarwal, Jorge Cerdá, on behalf of the AKI!Now Initiative of the American Society of Nephrology
CJASN Dec 2020, 15 (12) 1838-1847; DOI: 10.2215/CJN.15611219
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More in this TOC Section

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Keywords

  • acute kidney injury
  • critical care nephrology
  • AKI recognition
  • AKI awareness
  • AKI biomarkers
  • artificial intelligence
  • electronic alerts
  • AKI multidisciplinary management
  • AKI urinalysis
  • AKI pathology
  • incidence
  • goals
  • morbidity
  • kidney
  • hospital administrators
  • patient care team
  • quality of health care
  • intensive care units
  • longitudinal studies

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