Ambiguous definitions for baseline serum creatinine affect acute kidney diagnosis at the emergency department
| Autor: | Jan Willem Uffen, Romy Koopsen, Saskia Haitjema, Meriem Khairoun, Wouter M. Tiel Groenestege, Ayman El Idrissi, Domenico Bellomo, Karin A H Kaasjager, Wouter W. van Solinge, Michael Niemantsverdriet, Imo E. Hoefer |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Nephrology medicine.medical_specialty CKD-EPI Renal function urologic and male genital diseases chemistry.chemical_compound AKI Internal medicine Prevalence Humans Medicine Electronic health records Rifle Baseline (configuration management) Netherlands Retrospective Studies Creatinine business.industry Research Incidence (epidemiology) Acute kidney injury Emergency department Acute Kidney Injury Middle Aged medicine.disease Diseases of the genitourinary system. Urology chemistry Practice Guidelines as Topic Female RC870-923 Emergency Service Hospital business Digital health Biomarkers Glomerular Filtration Rate |
| Zdroj: | BMC Nephrology, Vol 22, Iss 1, Pp 1-10 (2021) BMC Nephrology |
| ISSN: | 1471-2369 |
| Popis: | Background Acute kidney injury (AKI) incidence is increasing, however AKI is often missed at the emergency department (ED). AKI diagnosis depends on changes in kidney function by comparing a serum creatinine (SCr) measurement to a baseline value. However, it remains unclear to what extent different baseline values may affect AKI diagnosis at ED. Methods Routine care data from ED visits between 2012 and 2019 were extracted from the Utrecht Patient Oriented Database. We evaluated baseline definitions with criteria from the RIFLE, AKIN and KDIGO guidelines. We evaluated four baseline SCr definitions (lowest, most recent, mean, median), as well as five different time windows (up to 365 days prior to ED visit) to select a baseline and compared this to the first measured SCr at ED. As an outcome, we assessed AKI prevalence at ED. Results We included 47,373 ED visits with both SCr-ED and SCr-BL available. Of these, 46,100 visits had a SCr-BL from the − 365/− 7 days time window. Apart from the lowest value, AKI prevalence remained similar for the other definitions when varying the time window. The lowest value with the − 365/− 7 time window resulted in the highest prevalence (21.4%). Importantly, applying the guidelines with all criteria resulted in major differences in prevalence ranging from 5.9 to 24.0%. Conclusions AKI prevalence varies with the use of different baseline definitions in ED patients. Clinicians, as well as researchers and developers of automatic diagnostic tools should take these considerations into account when aiming to diagnose AKI in clinical and research settings. |
| Databáze: | OpenAIRE |
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