Abstract：
OBJECTIVE: The KDIGO (Kidney Disease: Improving Global Outcomes) definition of acute kidney injury (AKI) is frequently used in studies to examine the epidemiology of AKI. This definition is variably interpreted and applied to routinely collected health care data. The aim of this study was to examine this variation and to achieve consensus in how AKI should be defined for research using routinely collected health care data.
UNASSIGNED: Scoping review via searching Medline and EMBASE for studies using health care data to examine AKI by using the KDIGO creatinine-based definition. An international panel of experts formed to participate in a modified Delphi process to attempt to generate consensus about how AKI should be defined when using routinely collected laboratory data.
UNASSIGNED: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) extension for scoping reviews was followed. For the Delphi process, 2 rounds of questions were distributed via internet-based questionnaires to all participants with a prespecified cutoff of 75% agreement used to define consensus.
RESULTS: The scoping review found 174 studies that met the inclusion criteria. The KDIGO definition was inconsistently applied, and the methods for application were poorly described. We found 58 (33%) of papers did not provide a definition of how the baseline creatinine value was determined, and only 34 (20%) defined recovery of kidney function. Of 55 invitees to the Delphi process, 35 respondents participated in round 1, and 25 participated in round 2. Some consensus was achieved in areas related to how to define the baseline creatinine value, which patients should be excluded from analysis of routinely collected laboratory data, and how persistent chronic kidney disease or nonrecovery of AKI should be defined.
CONCLUSIONS: The Delphi panel members predominantly came from the United Kingdom, the United States, and Canada, and there were low response rates for some questions in round 1.
CONCLUSIONS: The current methods for defining AKI using routinely collected data are inconsistent and poorly described in the available literature. Experts could not achieve consensus for many aspects of defining AKI and describing its sequelae. The KDIGO guidelines should be extended to include a standardized definition for how AKI should be defined when using routinely collected data.
UNASSIGNED: Scoping review via searching Medline and EMBASE for studies using health care data to examine AKI by using the KDIGO creatinine-based definition. An international panel of experts formed to participate in a modified Delphi process to attempt to generate consensus about how AKI should be defined when using routinely collected laboratory data.
UNASSIGNED: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) extension for scoping reviews was followed. For the Delphi process, 2 rounds of questions were distributed via internet-based questionnaires to all participants with a prespecified cutoff of 75% agreement used to define consensus.
RESULTS: The scoping review found 174 studies that met the inclusion criteria. The KDIGO definition was inconsistently applied, and the methods for application were poorly described. We found 58 (33%) of papers did not provide a definition of how the baseline creatinine value was determined, and only 34 (20%) defined recovery of kidney function. Of 55 invitees to the Delphi process, 35 respondents participated in round 1, and 25 participated in round 2. Some consensus was achieved in areas related to how to define the baseline creatinine value, which patients should be excluded from analysis of routinely collected laboratory data, and how persistent chronic kidney disease or nonrecovery of AKI should be defined.
CONCLUSIONS: The Delphi panel members predominantly came from the United Kingdom, the United States, and Canada, and there were low response rates for some questions in round 1.
CONCLUSIONS: The current methods for defining AKI using routinely collected data are inconsistent and poorly described in the available literature. Experts could not achieve consensus for many aspects of defining AKI and describing its sequelae. The KDIGO guidelines should be extended to include a standardized definition for how AKI should be defined when using routinely collected data.
摘要：
目的：KDIGO（肾脏疾病：改善全球结果）对急性肾损伤（AKI）的定义经常用于研究AKI的流行病学。此定义可变化地解释并应用于常规收集的医疗保健数据。这项研究的目的是检查这种变化，并在如何使用常规收集的医疗保健数据为研究定义AKI方面达成共识。
■通过搜索Medline和EMBASE，通过使用基于KDIGO肌酐的定义，使用医疗保健数据检查AKI的研究进行范围审查。成立了一个国际专家小组，参与了一个改良的Delphi流程，试图就使用常规收集的实验室数据时如何定义AKI达成共识。
■遵循用于范围审查的系统审查和荟萃分析（PRISMA）扩展的首选报告项目。对于Delphi过程，通过基于互联网的问卷向所有参与者分发了2轮问题，并预先指定了75％协议的界限来定义共识。
结果：范围审查发现174项符合纳入标准的研究。KDIGO的定义应用不一致，应用方法描述不充分。我们发现58（33％）的论文没有提供如何确定基线肌酐值的定义，只有34（20％）确定肾功能恢复。在Delphi流程的55名受邀者中，35名受访者参加了第一轮，25名受访者参加了第二轮。在与如何定义基线肌酐值相关的领域达成了一些共识。哪些患者应该被排除在常规收集的实验室数据分析之外，以及如何定义持续的慢性肾脏病或AKI不恢复。
结论：德尔福小组成员主要来自英国，美国,加拿大,在第一轮中，一些问题的回答率很低。
结论：目前使用常规收集的数据定义AKI的方法不一致，在现有文献中描述不佳。专家们无法在定义AKI和描述其后遗症的许多方面达成共识。应扩展KDIGO指南，以包括在使用常规收集的数据时应如何定义AKI的标准化定义。
■通过搜索Medline和EMBASE，通过使用基于KDIGO肌酐的定义，使用医疗保健数据检查AKI的研究进行范围审查。成立了一个国际专家小组，参与了一个改良的Delphi流程，试图就使用常规收集的实验室数据时如何定义AKI达成共识。
■遵循用于范围审查的系统审查和荟萃分析（PRISMA）扩展的首选报告项目。对于Delphi过程，通过基于互联网的问卷向所有参与者分发了2轮问题，并预先指定了75％协议的界限来定义共识。
结果：范围审查发现174项符合纳入标准的研究。KDIGO的定义应用不一致，应用方法描述不充分。我们发现58（33％）的论文没有提供如何确定基线肌酐值的定义，只有34（20％）确定肾功能恢复。在Delphi流程的55名受邀者中，35名受访者参加了第一轮，25名受访者参加了第二轮。在与如何定义基线肌酐值相关的领域达成了一些共识。哪些患者应该被排除在常规收集的实验室数据分析之外，以及如何定义持续的慢性肾脏病或AKI不恢复。
结论：德尔福小组成员主要来自英国，美国,加拿大,在第一轮中，一些问题的回答率很低。
结论：目前使用常规收集的数据定义AKI的方法不一致，在现有文献中描述不佳。专家们无法在定义AKI和描述其后遗症的许多方面达成共识。应扩展KDIGO指南，以包括在使用常规收集的数据时应如何定义AKI的标准化定义。
