Kidney Action Team

Acute kidney injury (AKI) is common in the hospital setting, occurring in up to 5-20% of hospitalized adults. Regardless of the stage, AKI is an independent risk factor for in-hospital mortality, with up to 50% mortality reported in studies and an even higher incidence reported in ICU settings. Due to its asymptomatic nature, especially when baseline creatinine is low or the trajectory is slow, AKI can go undetected for long periods of time and lead to irreversible kidney injury and eventually chronic kidney disease, which is itself associated with higher mortality. Early recognition and individualized intervention should therefore ameliorate these poor outcomes. In prior studies by our group, alerting primary providers of the occurrence of AKI on its own did not improve rates of AKI progression, dialysis requirement, or mortality. Instead of solely promoting early recognition of AKI, providing care teams with timely, actionable recommendations may result in better patient outcomes.

The Kidney Action Team (KAT) project is a multi-center, randomized, controlled trial that aims to assess the impact of automated AKI alerts coupled with personalized recommendations for hospitalized adults who experience AKI. As soon as AKI occurs, automated alerts are sent to a kidney action team that consists of physicians and pharmacists who will then provide personalized recommendations based on independent chart review prior to randomization. The study aims to enroll 4000 patients and will occur at a total of seven sites between two health systems - the Yale New Haven Hospital System and the Johns Hopkins Health System. Impact of personalized recommendations on provider behavior, AKI progression, dialysis and mortality will be assessed.

Melissa Martin
Research Associate, Yale University

Chirag R. Parikh, MD, PhD
Adjunct Professor of Medicine, Nephrology, Yale University and Chair, Division of Nephrology at Johns Hopkins University

Yu Yamamoto
Statistician, Yale University