Annals of intensive care · 2026
National variation in acute kidney injury diagnosis and monitoring across adult intensive care units in china: a nationwide cross-sectional survey.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Xinran, Zhang Xiuhua, Zhang Weiting, Xin Yu, Huang Pengfei, Liu Yanqi, Zeng Kai, Meng Xianglin, Peng Zhiyong, Li Wenxiong, Hu Zhenjie, Huang Yingzi, Duan Meili, Zhao Mingyan, Yu Kaijiang, Wang Changsong
Аннотация
BACKGROUND: Acute kidney injury (AKI) is common in critically ill patients and strongly associated with adverse outcomes, yet national ICU-level evidence on AKI diagnosis and monitoring in China remains limited.
METHODS: We conducted a nationwide anonymous cross-sectional web survey of adult ICUs in China from June 25 to September 26, 2025. The survey assessed AKI diagnosis and staging, UO and SCr monitoring across clinical scenarios, biomarker use, early warning systems, and changes in UO monitoring after AKI. We used multivariable logistic regression to identify factors associated with UO-monitoring practices, with FDR correction for multiple comparisons. An exploratory 0-100-point AKI-MIS summarised ICU-level monitoring implementation, with higher scores indicating broader implementation.
RESULTS: Of 2,002 responses, 1,896 unique adult ICU units were included. AKI diagnosis was reported by 97.9% of ICUs, whereas 63.2% explicitly implemented staging and 75.9% used both UO and SCr for diagnosis. Hourly UO monitoring increased from 49.6% in routine practice to 74.1% in sepsis, 75.0% in AKI, and 77.7% in sepsis-associated AKI. Dynamic UO monitoring was implemented in 14.8% of ICUs; 83.5% reported increased nursing workload, and 69.9% identified workload or insufficient staffing as the main barrier. After FDR correction, geographic region, nurse-to-bed ratio, and baseline monitoring intensity were associated with UO-monitoring practices. The median AKI-MIS was 68.1 (IQR, 60.3-74.9), with higher adjusted scores in teaching hospitals.
CONCLUSIONS: Among participating adult ICU units across all 31 provincial-level administrative regions of mainland China, AKI diagnosis and monitoring were widely reported, but substantial heterogeneity remained across monitoring systems. These findings provide a broad descriptive benchmark and identify priorities for strengthening standardisation, risk-responsive escalation, and closed-loop response pathways.
METHODS: We conducted a nationwide anonymous cross-sectional web survey of adult ICUs in China from June 25 to September 26, 2025. The survey assessed AKI diagnosis and staging, UO and SCr monitoring across clinical scenarios, biomarker use, early warning systems, and changes in UO monitoring after AKI. We used multivariable logistic regression to identify factors associated with UO-monitoring practices, with FDR correction for multiple comparisons. An exploratory 0-100-point AKI-MIS summarised ICU-level monitoring implementation, with higher scores indicating broader implementation.
RESULTS: Of 2,002 responses, 1,896 unique adult ICU units were included. AKI diagnosis was reported by 97.9% of ICUs, whereas 63.2% explicitly implemented staging and 75.9% used both UO and SCr for diagnosis. Hourly UO monitoring increased from 49.6% in routine practice to 74.1% in sepsis, 75.0% in AKI, and 77.7% in sepsis-associated AKI. Dynamic UO monitoring was implemented in 14.8% of ICUs; 83.5% reported increased nursing workload, and 69.9% identified workload or insufficient staffing as the main barrier. After FDR correction, geographic region, nurse-to-bed ratio, and baseline monitoring intensity were associated with UO-monitoring practices. The median AKI-MIS was 68.1 (IQR, 60.3-74.9), with higher adjusted scores in teaching hospitals.
CONCLUSIONS: Among participating adult ICU units across all 31 provincial-level administrative regions of mainland China, AKI diagnosis and monitoring were widely reported, but substantial heterogeneity remained across monitoring systems. These findings provide a broad descriptive benchmark and identify priorities for strengthening standardisation, risk-responsive escalation, and closed-loop response pathways.