Early Nephrology Consultation and Acute Kidney Injury in Hospitalized Patients: A Randomized Clinical Trial - Summary - MDSpire

Early Nephrology Consultation and Acute Kidney Injury in Hospitalized Patients: A Randomized Clinical Trial

  • By

  • Matthew M. Churpek

  • Aiman Fatima

  • Olasunkanmi Anjorin

  • Ananya Saravanan

  • Benjamin S. Ko

  • Samantha Gunning

  • Megan L. Prochaska

  • Tipu S. Puri

  • Anna L. Zisman

  • Dana P. Edelson

  • Mihai C. Giurcanu

  • Jay L. Koyner

  • Electronic Signal to Prevent Acute Kidney Injury (ESTOP-AKI) Investigative Team

  • Katherine Chen

  • Melody Dias

  • Joshua Gonzalez

  • Riley Hamilton

  • Alissa Kunczt

  • Christina Li

  • Kelly Minna

  • Sharon Trevino

  • July 10, 2026

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Objective:

To determine whether a structured, proactive early nephrology consultation (ENC) triggered by an elevated ESTOP-AKI risk score in patients without SCr-based AKI could minimize future peaks in SCr, prevent the development of AKI, and improve other patient-centered outcomes in a randomized clinical trial.

Approach:
  • Study Design: A single-center randomized clinical trial (RCT) was conducted at the University of Chicago Medicine.
  • Participants: Adult patients (≥18 years) hospitalized with an ESTOP-AKI score of at least 0.01 and without evidence of SCr-based AKI were eligible.
  • Randomization: Patients were randomized 1:1 to either ENC or usual care (UC) using permuted block randomization.
  • Intervention: The ENC involved a structured in-person consultation with nephrologists, focusing on six domains related to kidney care.
Key Findings:
  • The study aimed to assess the effectiveness of early nephrology consultations in preventing AKI.
  • Machine-learning AKI risk scores were utilized to identify at-risk patients.
  • The trial protocol was approved by the University of Chicago Institutional Review Board.
Interpretation:

The study addresses a gap in literature regarding proactive nephrology intervention prior to AKI development.

Limitations:
  • The study was conducted at a single center, which may limit generalizability.
  • Enrollment was paused due to the COVID-19 pandemic, potentially affecting sample size and outcomes.
Conclusion:

The study evaluates the impact of early nephrology intervention on AKI outcomes.

Original Source(s)

Early Nephrology Consultation and Acute Kidney Injury in Hospitalized Patients: A Randomized Clinical Trial

  • by Matthew M. Churpek, Aiman Fatima, Olasunkanmi Anjorin, Ananya Saravanan, Benjamin S. Ko, Samantha Gunning, Megan L. Prochaska, Tipu S. Puri, Anna L. Zisman, Dana P. Edelson, Mihai C. Giurcanu, Jay L. Koyner, Electronic Signal to Prevent Acute Kidney Injury (ESTOP-AKI) Investigative Team, Katherine Chen, Melody Dias, Joshua Gonzalez, Riley Hamilton, Alissa Kunczt, Christina Li, Kelly Minna, Sharon Trevino

  • July 10, 2026

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