Skip to main content

Akute Nierenschädigung – ein Problem des Gesundheitswesens

  • Chapter
  • First Online:
Akute Nierenschädigung

Zusammenfassung

Deutschland gehört zu den Ländern mit einer hohen Inzidenzrate der Nierenersatztherapie. Akute Nierenschäden werden in deutschen Krankenhäusern zunehmend dokumentiert. Sie sind wahrscheinlich dennoch unterdiagnostiziert. Ihre rechtzeitige fachliche Versorgung und die Vermeidung weiterer Schädigungen verbessern die Prognose der betroffenen Patienten. Ein Qualitätssicherungsprogramm für akute Nierenschäden hat zwei zentrale Komponenten: a) eine laborgestützte Früherkennung akuter Nierenschädigungen im Krankenhaus und b) ihre nachgehende Betreuung in der Akutklinik und im ambulanten Sektor. Beide Komponenten können schon jetzt mit messbaren Qualitätsindikatoren eingesetzt und ihre Effektivität belegt bzw. Aufwand und Zusatznutzen eines Qualitätsentwicklungsprogramm über diese Komponenten kontrolliert evaluiert werden.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 74.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • AQUA – Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH (2014): Qualitätsreport 2013. Göttingen

    Google Scholar 

  • Balasubramanian G, Al-Aly Z, Moiz A, Rauchman M, Zhang Z, Gopalakrishnan R, Balasubramanian S, El-Achkar TM. Early nephrologist involvement in hospital-acquired acute kidney injury: a pilot study. Am J Kidney Dis. 2011;57:228–234

    Article  PubMed  Google Scholar 

  • Caddeo G, Williams ST, McIntyre CW, Selby NM. Acute kidney injury in urology patients: incidence, causes and outcomes. Nephrourol 2013;5:955–961

    Google Scholar 

  • Caskey FJ, Schober-Halstenberg HJ, Roderick PJ, Edenharter G, Ansell D, Frei U, Feest TG. Exploring the differences in epidemiology of treated ESRD between Germany and England and Wales. Am J Kidney Dis. 2006;47:445–454

    Article  PubMed  Google Scholar 

  • Caskey FJ, Jager J. A population approach to renal replacement therapy epidemiology: lessons from the EVEREST study. Nephrol Dial Transplant. 2014;29:1494–1499

    Article  PubMed  Google Scholar 

  • Colpaert K, Hoste E, Steurbaut K, Benoit D, van Hoecke S, Turck F, Decruyenaere J. Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class. Crit Care Med. 2012;40:1164–1170

    Article  PubMed  Google Scholar 

  • Eberlein-Gonska M, Rink O. Peer Review - Fortschreiten in einem lernenden System. Drei Jahre Erfahrungen mit dem Peer-Review-Verfahren der Initiative Qualitätsmedizin – auf Grundlage der Ergebnisse in der Versorgung von Hirn- und Herzinfarkt sowie Herzinsuffizienz. Dtsch Arztebl. 2013;110:A 760–6

    Google Scholar 

  • Haase M, Robra BP, Hoffmann J, Isermann B, Henkel W, Bellomo R, Ronco C, Haase-Fielitz A. Management of acute kidney injury – is there an unmet medical need? Abstract MPO-090, Kongress der ERA-EDTA 2014, Amsterdam

    Google Scholar 

  • Harel Z, Wald R, Bargman JM, Mamdani M, Etchells E, Garg AX, Ray JG, Luo J, Li P, Quinn RR, Forster A, Perl J, Bell CM. Nephrologist follow-up improves all-cause mortality of severe acute kidney injury survivors. Kidney Int. 2013;83:901–8

    Article  PubMed  Google Scholar 

  • Kerr M, Bedford M, Matthews B, O'Donoghue D. The economic impact of acute kidney injury in England.Nephrol Dial Transplant. 2014 Jul;29(7):1362–8

    Article  PubMed  Google Scholar 

  • Kidney Disease: Improving Global Outcomes (KDIGO) AKI Work Group: KDIGO Clinical Practice Guideline for Acute Kidney Injury. In: Kidney International 2012; Supplements 2, S. 1–138

    Google Scholar 

  • Kidney Health for Life (KH4L): Chronic Kidney Disease Multinational Inventory. 2014; Brussels

    Google Scholar 

  • King N. Commentary on Wilson et al. Clin Trials. 2014;11:530–531

    Google Scholar 

  • Kucher N, Koo S, Quiroz R, Cooper JM, Paterno MD, Soukonnikov B, Goldhaber SZ. Electronic alerts to prevent venous thromboembolism among hospitalized patients. N Engl J Med. 2005;352:969–977

    Article  CAS  PubMed  Google Scholar 

  • Meier P, Bonfils RM, Vogt B, Burnand B, Burnier M. Referral patterns and outcomes in noncritically ill patients with hospital-acquired acute kidney injury. Clin J Am Soc Nephrol. 2011; 6: 2215–2225

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • National Confidential Enquiry into Patient Outcome and Death: Adding insult to injury. A review of the care of patients who died in hospital with a primary diagnosis of acute kidney injury (acute renal failure). London 2009

    Google Scholar 

  • Nimptsch U, Mansky T. Quality measurement combined with peer review improved German in-hospital mortality rates for four diseases. Health Aff (Millwood). 2013;32:1616–23

    Article  Google Scholar 

  • Selby NM, Crowley L, Fluck RJ, McIntyre CW, Monaghan J, Lawson N, Kolhe NV. Use of electronic results reporting to diagnose and monitor AKI in hospitalized patients. Clin J Am Soc Nephrol. 2012;7:533–40

    Article  PubMed  Google Scholar 

  • Siew E, Peterson JF, Eden SK, Hung AM, Speroff T, Ikizler TA, Matheny ME. Outpatient nephrology referral rates after acute kidney injury. J Am Soc Nephrol. 2012;23:305–312

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Smart NA, Dieberg G, Ladhani M, Titus T. Early referral to specialist nephrology services for preventing the progression to end-stage kidney disease. Cochrane Database Syst Rev. 2014;18:6:CD007333

    Google Scholar 

  • Southern Primary Care Partnerships 2012: Patient Kidney Care Card. http://www.carepathways4gp.org.uk/Acute_Kidney_Injury/AKI_pathway_files/Patient%20Kidney%20Care%20Card.pdf (21.10.2014)

  • Stang A, Stang M. Kardiovaskuläre Risikofaktoren im Bundeslandvergleich: Ein Beitrag zur Erklärung der hohen Mortalität der ischämischen Herzkrankheit in Sachsen-Anhalt. Dtsch Arztebl. 2014;111:530–536

    Google Scholar 

  • Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013;158:825–830

    Article  PubMed  Google Scholar 

  • Thomas ME, Sitch A, Baharani J, Dowswell G. Earlier intervention for acute kidney injury: evaluation of an outreach service and a long-term follow-up. Nephrol Dial Transplant. 2015 Feb;30(2):239–44

    Google Scholar 

  • Wallace K, Mallard AS, Stratton JD, Johnston PA, Dickinson S, Parry RG. Use of an electronic alert to identify patients with acute kidney injury. Clin Med. 2014;14:22–6

    Article  PubMed  Google Scholar 

  • van der Veer SN, Tomson CR, Jager KJ, van Biesen W. Bridging the gap between what is known and what we do in renal medicine: improving implementability of the European Renal Best Practice guidelines. Nephrol Dial Transplant. 2014;29:951–957

    Article  PubMed  Google Scholar 

  • Wang V, Maciejewski ML, Hammill BG, Hall RK, Van Scoyoc L, Garg AX, Jain AK, Patel UD. Recognition of CKD after the introduction of automated reporting of estimated GFR in the Veterans Health Administration. Clin J Am Soc Nephrol. 2014;9:29–36

    Article  PubMed Central  PubMed  Google Scholar 

  • Wilson FP, Bansal AD, Jasti SK, Lin JJ, Shashaty MG, Berns JS, Feldman HI, Fuchs BD. The impact of documentation of severe acute kidney injury on mortality. Clin Nephrol. 2013;80:417–425

    Article  PubMed Central  PubMed  Google Scholar 

  • Wilson FP, Reese PP, Shashaty MG, Ellenberg SS, Gitelman Y, Bansal AD, Urbani R, Feldman HI, Fuchs B. A trial of in-hospital, electronic alerts for acute kidney injury: design and rationale. Clin Trials. 2014;11:521–529

    Article  PubMed  Google Scholar 

  • Wilson FP, Shashaty M, Testani J, Aqeel I, Borovskiy Y, Ellenberg SS, Feldman HI, Fernandez H, Gitelman Y, Lin J, Negoianu D, Parikh CR, Reese PP, Urbani R, Fuchs B. Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial. Lancet. 2015 Feb 25. pii:S0140-6736(15)60266-5

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael Haase .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Haase, M., Haase-Fielitz, A., Robra, BP. (2015). Akute Nierenschädigung – ein Problem des Gesundheitswesens. In: Haase, M., Haase-Fielitz, A. (eds) Akute Nierenschädigung. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45080-8_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-45080-8_7

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-45079-2

  • Online ISBN: 978-3-642-45080-8

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics