2024
Early, Individualized Recommendations for Hospitalized Patients With Acute Kidney Injury
Aklilu A, Menez S, Baker M, Brown D, Dircksen K, Dunkley K, Gaviria S, Farrokh S, Faulkner S, Jones C, Kadhim B, Le D, Li F, Makhijani A, Martin M, Moledina D, Coronel-Moreno C, O’Connor K, Shelton K, Shvets K, Srialluri N, Tan J, Testani J, Corona-Villalobos C, Yamamoto Y, Parikh C, Wilson F, Sundararajan A, Wang A, Schretlen C, Singel D, Moss E, Aune F, Iantosca G, Zou G, Chernova I, Bitzel J, Hernandez J, Lindsley J, Dane K, Orias M, Mehta P, Zassman-Isner S, Wen Y, Freeman N. Early, Individualized Recommendations for Hospitalized Patients With Acute Kidney Injury. JAMA 2024, 332 PMID: 39454050, DOI: 10.1001/jama.2024.22718.Peer-Reviewed Original ResearchElectronic health recordsUsual careHealth recordsAction teamsClinicians of patientsHospitalized patientsFinal follow-upIntervention groupHealth systemStudy pharmacistsStudy physiciansMain OutcomesAssociated with adverse outcomesAcute kidney injuryRandomized clinical trialsPrimary outcomeIndividualized recommendationsNew HavenAdverse outcomesAKI detectionCareRhode IslandComposite outcomeFollow-upInterventionThe utility of urine sodium–guided diuresis during acute decompensated heart failure
Siddiqi H, Cox Z, Stevenson L, Damman K, ter Maaten J, Bales B, Han J, Ivey-Miranda J, Lindenfeld J, Miller K, Ooi H, Rao V, Schlendorf K, Storrow A, Walsh R, Wrenn J, Testani J, Collins S. The utility of urine sodium–guided diuresis during acute decompensated heart failure. Heart Failure Reviews 2024, 29: 1161-1173. PMID: 39128947, PMCID: PMC11455821, DOI: 10.1007/s10741-024-10424-8.Peer-Reviewed Original ResearchAcute decompensated heart failureDecompensated heart failureHeart failureClinical trialsUrine sodium excretionObservational cohort studyRandomized clinical trialsAdequate decongestionDiuretic strategySodium excretionUrine chemistryCohort studyTitration strategyUrineDiuretic titrationAdverse effectsDiuresisDecongestionPatientsUsual careEvidence gapsTrialsTherapyFailure
2023
Randomized controlled trial of urinE chemiStry guided aCute heArt faiLure treATmEnt (ESCALATE): Rationale and design
Cox Z, Siddiqi H, Stevenson L, Bales B, Han J, Hart K, Imhoff B, Ivey-Miranda J, Jenkins C, Lindenfeld J, Shotwell M, Miller K, Ooi H, Rao V, Schlendorf K, Self W, Siew E, Storrow A, Walsh R, Wrenn J, Testani J, Collins S. Randomized controlled trial of urinE chemiStry guided aCute heArt faiLure treATmEnt (ESCALATE): Rationale and design. American Heart Journal 2023, 265: 121-131. PMID: 37544492, PMCID: PMC10592235, DOI: 10.1016/j.ahj.2023.07.014.Peer-Reviewed Original ResearchAcute decompensated heart failureUrine chemistryDiuretic strategyIntravenous diuresisUsual careAcute heartHeart failureClinical trialsGlobal clinical statusKey exclusion criteriaUsual care strategyAcute heart failureDecompensated heart failureRandomized clinical trialsKey inclusion criteriaMultiple clinical trialsPaucity of evidenceDiuretic dosingDiuretic therapyPrimary outcomePatient's symptomsClinical statusTreatment trialsValvular stenosisClinical stateA randomized clinical trial assessing the effect of automated medication-targeted alerts on acute kidney injury outcomes
Wilson F, Yamamoto Y, Martin M, Coronel-Moreno C, Li F, Cheng C, Aklilu A, Ghazi L, Greenberg J, Latham S, Melchinger H, Mansour S, Moledina D, Parikh C, Partridge C, Testani J, Ugwuowo U. A randomized clinical trial assessing the effect of automated medication-targeted alerts on acute kidney injury outcomes. Nature Communications 2023, 14: 2826. PMID: 37198160, PMCID: PMC10192367, DOI: 10.1038/s41467-023-38532-3.Peer-Reviewed Original ResearchConceptsAcute kidney injuryUsual care groupKidney injuryCare groupAcute Kidney Injury OutcomesAlert groupNon-steroidal anti-inflammatory drugsComposite of progressionHours of randomizationMedications of interestAldosterone system inhibitorsClasses of medicationsProton pump inhibitorsRandomized clinical trialsAnti-inflammatory drugsClinical decision support systemNephrotoxic medicationsHospitalized adultsDiscontinuation ratesCertain medicationsPrimary outcomeSubstantial morbiditySystem inhibitorsPump inhibitorsParallel group
2015
Evaluation of Short-Term Changes in Serum Creatinine Level as a Meaningful End Point in Randomized Clinical Trials
Coca SG, Zabetian A, Ferket BS, Zhou J, Testani JM, Garg AX, Parikh CR. Evaluation of Short-Term Changes in Serum Creatinine Level as a Meaningful End Point in Randomized Clinical Trials. Journal Of The American Society Of Nephrology 2015, 27: 2529-2542. PMID: 26712525, PMCID: PMC4978048, DOI: 10.1681/asn.2015060642.Peer-Reviewed Original ResearchConceptsSerum creatinine levelsCreatinine levelsClinical trialsEnd pointAcute elevationRandomized trialsAcute changesPlacebo-controlled randomized trialSafety end pointRandomized clinical trialsStrong risk factorMeaningful clinical outcomesMeaningful end pointsClinical outcomesKidney functionPoor outcomeAcute increaseRisk factorsThorough literature searchObservational studyTemporary elevationMortality rateShort-term effectsPlaceboCKD