Randomized trial of AKI alerts in hospitalized patients

Objective: To determine whether electronic health record (EHR) alerts for Acute Kidney Injury (AKI) would improve patient outcomes of mortality, dialysis and progression of AKI. 

Design: Double-blinded, multicenter, parallel, randomized, controlled trial of an electronic AKI alert versus usual care (no alert). Participants were electronically identified and randomized via a best practice alert build using simple randomization with allocation concealment.

Setting: Six diverse hospitals (four teaching and two non-teaching) ranging from small community hospitals to large tertiary care centers.

Participants: 6,030 adult inpatients with AKI, as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) creatinine criteria.

Interventions: An  EHR-based “pop-up” alert for AKI with an associated AKI order set upon provider opening of the patient’s medical record.

Main Outcome Measures: A composite of AKI progression, receipt of dialysis, or death within 14 days of randomiza...