Digital health and acute kidney injury: consensus report of the 27th Acute Disease Quality Initiative workgroup

• Published in: Nature reviews. Nephrology 2023-12, Vol.19 (12), p.807-818
• Main Authors: Kashani, Kianoush B., Awdishu, Linda, Bagshaw, Sean M., Barreto, Erin F., Claure-Del Granado, Rolando, Evans, Barbara J., Forni, Lui G., Ghosh, Erina, Goldstein, Stuart L., Kane-Gill, Sandra L., Koola, Jejo, Koyner, Jay L., Liu, Mei, Murugan, Raghavan, Nadkarni, Girish N., Neyra, Javier A., Ninan, Jacob, Ostermann, Marlies, Pannu, Neesh, Rashidi, Parisa, Ronco, Claudio, Rosner, Mitchell H., Selby, Nicholas M., Shickel, Benjamin, Singh, Karandeep, Soranno, Danielle E., Sutherland, Scott M., Bihorac, Azra, Mehta, Ravindra L.
• Format: Article
• Language: English
• Subjects: 631/114/1305; 639/166/985; 692/308/2779/109; 692/4022/1585/4; Acute Disease; Acute Kidney Injury - diagnosis; Acute Kidney Injury - etiology; Acute Kidney Injury - therapy; Adult; Child; Clinical medicine; Consensus; Consensus Statement; Critical Care; Data science; Decision making; Digital divide; Digital technology; Disease prevention; Electronic health records; Empowerment; Health care delivery; Humans; Information technology; Innovations; Kidneys; Medicine; Medicine & Public Health; Nephrology; Patients; Pharmacy; Professional ethics; R&D; Research & development; Subacute care; Telemedicine
• ISSN: 1759-5061; 1759-507X; 1759-507X
• DOI: 10.1038/s41581-023-00744-7

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. In this Consensus Statement, the authors discuss a framework for the development, validation and implementation of digital health technologies across the acute kidney injury continuum — risk prediction, prevention, detection and management.