Study finds that team-based coaching reduces risks of acute kidney injury after heart procedures (46% fewer ACIs)

Medical Xpress / The Geisel Schl of Med at Dartmouth / Clinical Jrnl of the Am. Soc of Nephrology ^ | Jan. 19, 2023 | Timothy Dean / Jeremiah Brown, Ph.D.

[ConservativeMind]

Findings from a study show an implementation science approach using team-based coaching and automated surveillance reporting significantly reduces the risk of acquiring post-procedural acute kidney injury (AKI) when compared to other interventions.

Up to 14 percent people who undergo cardiac catheterization procedures each year experience acute kidney injury (AKI).

Research has shown there are basic steps that cardiovascular interventional teams can take to help prevent AKIs. These include ensuring that patients are well-hydrated going into procedures and that they receive an IV fluid bolus, allowing them to eat and drink up to two hours before procedures, and limiting the amount of contrast dye used in procedures.

"The problem is that only about 25 percent of medical centers or cardiovascular interventional teams at those sites are applying the evidence base or official guidelines from leading consortiums like KDIGO (Kidney Disease: Improving Global Outcomes)," says Jeremiah Brown, Ph.D.

The investigators measured the effectiveness and implementation of three different monthly interventions in preventing AKI at 20 VA medical centers across the country over an 18-month period. Half the centers received team-based coaching sessions in a virtual learning collaborative (Collaborative) and half received technical one-on-one assistance (Assistance) from a nephrologist expert in AKI prevention. The two main groups were further randomized to either receive a surveillance dashboard report (Surveillance) that provided automated feedback on key performance metrics or no report (No Surveillance).

A total of 4,517 patients participated, with 510 experiencing acute kidney injury. The study team found that the Collaborative with Surveillance intervention significantly outperformed the other groups, reducing the odds of AKI by 46 percent—to date the best finding in the field. Comparatively, the Collaborative with No Surveillance group and the Assistance with Surveillance group saw a 28 percent and a 24 percent reduction in the odds of AKI, respectively.

[ConservativeMind]

75% of cardio teams/ doctors don’t know how to minimize acute kidney injury for their patients, so up to 14% of their patients will get it.

[ConservativeMind]

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