Provider knowledge of contrast-induced acute kidney injury.

Jasuja D, Mor MK, Hartwig KC, Palevsky PM, Fine MJ, Weisbord SD. Provider knowledge of contrast-induced acute kidney injury. The American journal of the medical sciences. 2009 Oct 1; 338(4):280-6.

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Abstract:

BACKGROUND: Although past research has elucidated the principal risk factors and efficacy of preventive interventions for contrast-induced acute kidney injury (CIAKI), provider awareness of this empiric evidence base is largely unknown. We sought to assess provider knowledge of the risk factors and preventive interventions for CIAKI. METHODS: We asked medical providers caring for patients undergoing procedures with intravascular iodinated contrast to complete a survey designed to assess their knowledge of the risk factors and preventive interventions for CIAKI. RESULTS: Of the 87 participating providers, nearly all (n = 85; 98%) recognized chronic kidney disease and intravascular volume depletion as risk factors. However, 35 (41%) incorrectly identified allergy to contrast media as a risk factor and 8 (10%) incorrectly identified intravenous (IV) water as an effective preventive intervention. Compared with those with little or no prior training on CIAKI, those with substantial prior training correctly reported that peripheral vascular disease and atrial fibrillation are not risk factors and that fenoldopam and IV water are ineffective preventive interventions (P < 0.05). Trainees were more likely than those who had completed their postgraduate medical training to correctly report that IV saline and sodium bicarbonate are effective preventive interventions and that fenoldopam, dopamine, mannitol, and IV water are ineffective measures (P < 0.05). CONCLUSIONS: There is wide variability in providers'' knowledge of CIAKI. Providers with more training on CIAKI and trainees had greater knowledge of the risk factors and preventive interventions for CIAKI. These findings underscore the need to standardize and intensify provider education of this costly and preventable iatrogenic condition.