{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T06:21:05Z","timestamp":1773382865697,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T00:00:00Z","timestamp":1696550400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science, Research and Cultural Affairs of the State of Brandenburg"},{"name":"Brandenburg Medical School Theodor Fontane, Germany"},{"name":"MHB publication fund"},{"name":"DFG"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Detection and timely intervention of acute kidney injury (AKI) is a major challenge worldwide. Electronic alerts for AKI may improve process- and patient-related endpoints. The present study evaluated the efficacy of an AKI electronic alert system and care bundle. This is a two-arm, prospective, cluster-randomized, controlled trial enrolling patients with AKI (KDIGO criteria) and cardiac diseases. Patients were randomly assigned to a routine care group or intervention group (DRKS-IDDRKS00017751). Two hundred patients (age 79 years, 46% female) were enrolled, with 100 patients in each group. The primary endpoint did not differ between patients in the routine care group 0.5 (\u22127.6\u201310.8) mL\/min\/1.73 m2 versus patients in the intervention group 1.0 (\u221213.5\u201315.1) mL\/min\/1.73 m2, p = 0.527. Proportions of patients in both study groups with hyperkalemia, pulmonary edema, and renal acidosis were comparable. The stop of antihypertensive medication during hypotensive periods was more frequent in patients in the intervention group compared to patients in the control group, p = 0.029. The AKI diagnosis and text module for AKI in the discharge letter were more frequently documented in patients in the intervention group (40%\/48% vs. 25%\/34%, p = 0.034; p = 0.044, respectively). Continued intake of RAAS inhibitors and the presence of a cardiac device were independently associated with a less pronounced decrease in eGFR from admission to the lowest value. In this RCT, electronic alerts for AKI and a care bundle improved process- but not patient-related endpoints.<\/jats:p>","DOI":"10.3390\/jcm12196391","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T04:52:36Z","timestamp":1696827156000},"page":"6391","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Care Bundle for Acute Kidney Injury in Cardiac Patients: A Cluster-Randomized Trial"],"prefix":"10.3390","volume":"12","author":[{"given":"Ragna","family":"Iwers","sequence":"first","affiliation":[{"name":"Department of Cardiology, Heart Center Brandenburg Bernau & Faculty of Health Sciences (FGW) Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Ladeburger Str. 17, 16321 Bernau bei Berlin, Germany"},{"name":"Institute of Social Medicine and Health System Research, Otto von Guericke University Magdeburg, 39120 Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronika","family":"Sliziuk","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Center Brandenburg Bernau & Faculty of Health Sciences (FGW) Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, 16321 Bernau bei Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Haase","sequence":"additional","affiliation":[{"name":"Medical Faculty, Otto-von-Guericke University Magdeburg, 39106 Magdeburg, Germany"},{"name":"Diamedikum MVZ, 14473 Potsdam, Germany"},{"name":"Department of Nephrology and Hypertension, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Barabasch","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Unfallkrankenhaus Berlin, 12683 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Z\u00e4nker","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Internal Medicine, Heart Center Brandenburg Bernau & Faculty of Health Sciences (FGW) Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, 16321 Bernau bei Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Butter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Brandenburg Bernau & Faculty of Health Sciences (FGW) Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Ladeburger Str. 17, 16321 Bernau bei Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6881-2249","authenticated-orcid":false,"given":"Anja","family":"Haase-Fielitz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Brandenburg Bernau & Faculty of Health Sciences (FGW) Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Ladeburger Str. 17, 16321 Bernau bei Berlin, Germany"},{"name":"Institute of Social Medicine and Health System Research, Otto von Guericke University Magdeburg, 39120 Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1038\/s41581-018-0052-0","article-title":"Global epidemiology and outcomes of acute kidney injury","volume":"14","author":"Hoste","year":"2018","journal-title":"Nat. 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