Report on Early Detection of Acute Kidney Injury in Adults

This report, prepared by a third-year nursing student, investigates the clinical effectiveness of prompt referral to nephrology services for adults at risk of developing acute kidney injury (AKI). The report emphasizes the importance of early detection for improved patient outcomes and utilizes an annotated bibliography to analyze three key articles. The articles explore various research methods, including parallel randomized trials, cross-sectional data analysis, and the use of databases like Med-line and Pub-Med. The report also discusses the relevance of the research findings to nursing practice, highlights barriers to effective practice, such as communication challenges and knowledge gaps, and emphasizes the need for evidence-based practice and respect for patient values. The references include books, journals, and online resources related to AKI and nursing practice.

Template to use for assessment 3
Assessment 3Introduction- Acute kidney injury is one of the most serious and challenging
problem. Early detection in acute kidney injury and alteration in treatment can lead to reduce in
risk of developing the problem further. It is very important to detect the disorder in early stage
as it can lead to improvement in patient outcome.
As, a third year nursing student I am keen interested in this topic, as the early detection
of acute kidney injury allow timely preventive and therapeutic measures (Zuk & Bonventre,
(2016).
The main aim of the assignment is to measure clinical effectiveness of prompt referral to
nephrology services for adults which are at risk of developing disease.
Best EvidenceBest PracticeLevel of EvidenceStudy DesignIn-text Citation in CDU APA
6th Format There was a decrease in the mortality rate of adults suffering from acute kidney
injury Moderate quality level of evidence Parallel randomized trials (Patschan & Müller,
(2015) No discrimination done by nurses to the patients suffering from this disease High quality
level of evidence Cross-sectional data analysis (Angeli et.al., (2015) Principles of ethical
research was also followed which helped in better understanding patients Moderate quality level
of evidence Data analysis by Aca method (Young et.al., (2015).
Annotated Bibliography Article 1
National Institute for Health and Care Excellence, August 2013. Acute kidney injury
Prevention, detection and management up to the point of renal replacement therapy, National
Clinical Guideline Centre. Doi: 10.5249
Background of authors

Many authors like Duncan, Edwards, Purshura, Tucker has conducted the study to detect
and prevent acute kidney injury. The study consisted of variety of PEWS tools and also added
novels which were written by the same authors. The authors used report data based on PICU
admissions.
Aim of the research
Main objective of the research was to identify how the acute kidney failure can be
detected early and help in improving outcome of patients
Research methods
The design of the study which was chosen for the study includes parallel randomized
trials that can be used in producing unbiased computation of the intervention effect. Cross-
sectional, prospective and retrospective studies were also included. For doing data analysis ACA
method was used. The non-randomized sample was implemented in the research. Data was
collected through interviewing patients and recording their outcomes (Patschan & Müller,
(2015).
Relevance of the result
The result of the research has helped in better understanding and detecting the problem at
an early stage.
Conclusion made by author
The author has stated that early detection has helped in improving patient outcome.
Article 2
Yavuzer Koza, 2016 Jan Acute kidney injury: current concepts and new insights, Department of
Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey. Doi: 10.5249
Background of author

Yavuzer Koza is a researcher at Ataturk University Faculty of Medicine who has
conducted the research in order to have a knowledge about acute kidney injury, concepts and
insights.
Aim of the research
The main objective of the study was to reduce the impact of acute kidney injury and
early detection of it.
Research methods
The literature covered in the article was based on definition, biomarkers, administration
and epistemology related to disease were discussed by searching key-terms using Med-line and
Pub-Med databases (Angeli et.al., (2015).
Relevance of results
The biomarkers, epidemiology and pathophysiology used in the article has helped in
improving knowledge and learning related to the disease.
Conclusion made by author
The author concluded that acute kidney injury is a very harmful disease and all
measure of preventive care should be taken by patients.
Article 3
J. Koeze et.al., 2017 Incidence, timing and outcome of AKI in critically ill patients varies with
the definition used and the addition of urine output criteria. Department of Critical
Care University of Groningen, University Medical Centre Groningen. DOI 10.1186
Background of the authors

Koeze and other author has conducted the study to know about the condition and
outcome of patient suffering from acute kidney injury.
Main aim of research
The main objective of the study was to know which of the AKI definitions (RIFLE,
AKIN or KDIGO) with or without urine outflow way analyses AKI most significantly and
quickest.
Research methods
The population sample used in the research was patient who were admitted in ICU
because of disease. The search was made using Pub-Med and also comparison was done between
RIFLE, AKIN AND KDIGO. Also, keywords like incidence, intensive care were also being
searched. The information was collected using base-line data which recorded. It gathered data
related to patients age, sex, disease. Mortality rate of service users admitted in ICU ward was
also recorded in this (Young et.al., (2015).
Relevance of results
The result obtained from the research was appropriate, it has helped in understanding the
signs and symptoms which would help in early detection
Conclusion made by authors
The author has stated the conclusion made from the research that AKIN AND KDIGO
approach helps in detecting more early signs of disease
Justifying the Evidence Justifying the evidence
Article 1- The article focused on Acute kidney injury Prevention, detection and
management up to the point of renal replacement therapy. The research method which was used
in the study was parallel randomized trial. Strength of this method was that the decisions were
taken by engaging both patients and health-care professionals. The trail has helped service users

in enhancing their knowledge and awareness regarding their condition. The trail also has certain
limitations which includes that it requires collaboration with large number of experienced health-
care professionals. Cross sectional method was also being utilize in the study. The strength of the
approach includes that the information collected by this, can be used in various type of research.
And also, the method used was very cost effective. The only limitation of this approach was the
behavior which cannot be analyzed over a period. The result obtained was relevant as it helped
in detecting the issue at an early level which was also related to the main aim of research
(Murray et.al., (2014).
Article 2- The article focused on Acute kidney injury: current concepts and new insights.
The research methods which was used in the study was searching keywords in Med-line and
Pub-Med databases. The strength of these databases were that they supported in doing peer-
review in order to make sure that the research was well designed. The sources helped
researchers in gathering numerous results about the topic and provide nurses with relevant
information that can help them in better understanding the disease.
The limitation of this method was researchers has to make sure about the relevancy of
data collected from this approach. The bio-markers used in the study has also supported authors
in knowing the entire spectrum related to the disease and help in the early manifestation of the
disorder. The limitation of this research is measurement error which occur while gathering of
information related to disease. (Bihorac et.al., (2014). The result was relevant that the
epidemiology, bio-markers and pathophysiology supports in better understanding and early
detection of disease which was the main aim of the research.
Article 3- The article focused on Incidence, timing and outcome of AKI in critically ill
patients which varies with the definition used and the addition of urine output criteria. In this
study the search was made using Pub-med. The strength of the method was specific information
related to the diagnosis, signs, symptoms and treatment related to the disease. All the searches
presented in this were done by many experienced as well as trained health-care professionals. It
can help nurses in analyzing the changes in behavior of patient during disease more easily.
Limitation of this research method was that the author has to make sure about authentication of
sources.

The result showed that by analyzing the outcome of urine, the disease can be detected by
health-care professional at an early stage. It has helped in achieving the main of the research.
Also, the article supported in providing effective and efficient treatment to patients.
Relevance to Nursing and Barriers to Practice
Relevance to nursing and barriers to practice
For making the research more efficient, nurses had made use of principles relating to
evidence based practice. They have the responsibility to provide respect to patient’s value.
Patient value can be implementation by keen analyzing the patient’s behavior and trying
communicate with them. Effective interaction can support them in understanding patients value,
culture and beliefs. In order to improve health-outcomes of service users suffering from acute
kidney injury, patient-value can be implemented as it aim at respecting beliefs, thoughts and
culture of service users. It may also be implemented by working on the principles of honesty,
compliance and beneficence.
The barriers which can be faced by nurses are related to patients value where there are
chances that health-care professionals are not able to understand the needs of service users
because of the lack of communication and cultural differences was not able to understand the
patients’ needs and demands. (Communication Barriers Perceived by Nurses and Patients,
(2015). Another barrier can be sufficient knowledge about service users values also make them
ineffective in their treatment. Common barriers which can be occur while understanding patient
value can be that the nurses may be unable to collect information related to patient’s value and
has no access to relevant sources.

REFERENCES
Books and journals
Zuk, A., & Bonventre, J. V. (2016). Acute kidney injury. Annual review of medicine.67. 293-
307.
Patschan, D., & Müller, G. A. (2015). Acute kidney injury. Journal of Injury and Violence
Research.7(1). 19.
Angeli, P., Ginès, P., Wong, F., Bernardi, M., Boyer, T. D., Gerbes, A., ... & Moore, K. (2015).
Diagnosis and management of acute kidney injury in patients with cirrhosis: revised
consensus recommendations of the International Club of Ascites. Gut, gutjnl-2014.
Young, P., Bailey, M., Beasley, R., Henderson, S., Mackle, D., McArthur, C., ... & Reddy, S.
(2015). Effect of a buffered crystalloid solution vs saline on acute kidney injury among
patients in the intensive care unit: the SPLIT randomized clinical trial. Jama.314(16).
1701-1710.
Murray, P. T., Mehta, R. L., Shaw, A., Ronco, C., Endre, Z., Kellum, J. A., ... & Okusa, M. D.
(2014). Potential use of biomarkers in acute kidney injury: report and summary of
recommendations from the 10th Acute Dialysis Quality Initiative consensus
conference. Kidney international.85(3).513-521.
Bihorac, A., Chawla, L. S., Shaw, A. D., Al-Khafaji, A., Davison, D. L., DeMuth, G. E., ... &
Heung, M. (2014). Validation of cell-cycle arrest biomarkers for acute kidney injury
using clinical adjudication. American journal of respiratory and critical care
medicine.189(8). 932-939.
Online
Communication Barriers Perceived by Nurses and Patients. (2015). [ONLINE] Available
through: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4954910/>

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