Division of Nephrology and Hypertension, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Clinical Pharmacy, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.
Nat Rev Nephrol. 2023 Dec;19(12):807-818. doi: 10.1038/s41581-023-00744-7. Epub 2023 Aug 14.
Acute kidney injury (AKI), which is a common complication of acute illnesses, affects the health of individuals in community, acute care and post-acute care settings. Although the recognition, prevention and management of AKI has advanced over the past decades, its incidence and related morbidity, mortality and health care burden remain overwhelming. The rapid growth of digital technologies has provided a new platform to improve patient care, and reports show demonstrable benefits in care processes and, in some instances, in patient outcomes. However, despite great progress, the potential benefits of using digital technology to manage AKI has not yet been fully explored or implemented in clinical practice. Digital health studies in AKI have shown variable evidence of benefits, and the digital divide means that access to digital technologies is not equitable. Upstream research and development costs, limited stakeholder participation and acceptance, and poor scalability of digital health solutions have hindered their widespread implementation and use. Here, we provide recommendations from the Acute Disease Quality Initiative consensus meeting, which involved experts in adult and paediatric nephrology, critical care, pharmacy and data science, at which the use of digital health for risk prediction, prevention, identification and management of AKI and its consequences was discussed.
急性肾损伤（AKI）是急性疾病的常见并发症，影响社区、急性护理和康复后护理环境中个体的健康。尽管过去几十年来 AKI 的识别、预防和管理已经取得了进展，但它的发病率及其相关的发病率、死亡率和医疗保健负担仍然巨大。数字技术的快速发展为改善患者护理提供了一个新的平台，报告显示在护理过程中以及在某些情况下在患者结局中都有明显的获益。然而，尽管取得了巨大的进展，但利用数字技术来管理 AKI 的潜在获益尚未在临床实践中得到充分探索或实施。AKI 的数字健康研究显示出获益的证据存在差异，而且数字鸿沟意味着并非所有人都能平等地获得数字技术。上游的研发成本、利益相关者参与和接受程度有限，以及数字健康解决方案的可扩展性差，都阻碍了它们的广泛实施和应用。在这里，我们提供了急性病质量倡议共识会议的建议，该会议涉及成人和儿科肾脏病学、重症监护、药学和数据科学方面的专家，会上讨论了利用数字健康进行 AKI 及其后果的风险预测、预防、识别和管理。
