National variation in acute kidney injury diagnosis and monitoring across adult intensive care units in china: a nationwide cross-sectional survey
Authors' conclusion
Among participating adult ICU units across all 31 provincial-level administrative regions of mainland China, AKI diagnosis and monitoring were widely reported, but substantial heterogeneity remained across monitoring systems.
Study context
- Population
- Adult ICUs in China
- Participants
- 1,896 unique adult ICU units
- Outcome
- AKI diagnosis and monitoring practices
Methodological detailsnationwide, anonymous web survey, Survey June 25 to September 26, 2025; 2,002 responses
- Nationwide
- Anonymous web survey
- Survey June 25 to September 26, 2025; 2,002 responses
Main finding
As reported in the abstract
- Acute kidney injury (AKI) diagnosis reported
- 97.9%
- Staging explicitly implemented
- 63.2%
- Both UO and SCr used for diagnosis
- 75.9%
- Hourly UO monitoring, routine practice
- 49.6%
- Hourly UO monitoring, sepsis
- 74.1%
- Hourly UO monitoring, AKI
- 75.0%
- Hourly UO monitoring, sepsis-associated AKI
- 77.7%
- Dynamic UO monitoring implemented
- 14.8%
Observational data: associations, not effects.
Further findings
Nursing workload with dynamic UO monitoring
- Increased nursing workload reported
- 83.5%
- Workload or insufficient staffing as main barrier
- 69.9%
Factors associated with UO-monitoring practices
- Geographic region, nurse-to-bed ratio and baseline monitoring intensity associated with UO-monitoring practices
- After FDR correction
AKI-MIS (0-100, higher = broader implementation)
- Median AKI-MIS, IQR 60.3-74.9
- 68.1
- Higher adjusted scores in teaching hospitals
- Exploratory
Original publication
National variation in acute kidney injury diagnosis and monitoring across adult intensive care units in china: a nationwide cross-sectional survey. Ann Intensive Care. Published 22 September 2026. doi:10.
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