Epidemiologic Investigation of Contrast-Induced AKI Based on an In-Hospital Electronic Monitoring System

Background: With the gradual promotion of cardiovascular disease interventions , contrast-induced acute kidney injury (CI-AKI) has become the third most common cause of medically induced kidney injury. Patients with CI-AKI have a poor prognosis, which increases the incidence of end-stage renal disease and the risk of death, and the 2-year survival rate for patients with CI-AKI requiring dialysis is only 18.8%.AKI alerts and corresponding interventions based on electronic surveillance system data have been shown in selected studies to improve AKI patient regression, reduce AKI-related mortality, and decrease hospital length of stay. Methods: 11,874 adult inpatients who underwent angiography with contrast agents at Ningbo No. 2 Hospital from June 1, 2019 to April 30, 2024 were included, and patients with CI-AKI were screened by an in-hospital electronic monitoring system according to the Kidney Disease Improvement Global Prognosis Organization (KDIGO) criteria. Results: Of the 11,874 hospitalized patients, 63.36% were male, with an age distribution of 2.08% between 18 and 40 years old, 39.49% between 41 and 65 years old, and 58.43% 66 years old and over.The electronic monitoring system detection rate was 10.49% (1245/11874), of which only 7.47% (93/1245) patients with CI-AKI were invited to nephrologists for consultation, and only 5.30% (66/1245) patients with CI-AKI were discharged with a diagnosis that included an AKI-related diagnosis (acute renal insufficiency/acute renal failure/acute renal damage/acute kidney injury). Of the CI-AKI patients, 46.67% (581/1245) were medical patients, 22.41% (279/1245) were surgical patients, and 30.12% (375/1245) were in intensive care medicine. Conclusion: The majority of physicians have insufficient knowledge of CI-AKI, serious underdiagnosis, and low consultation rate in nephrology. The establishment of an in-hospital electronic monitoring system is extremely important for improving the prevention and diagnosis of AKI and improving the prognosis of patients. Funding: Government Support – Non-U.S.