Acute kidney injury (AKI) is common, serious and expensive.It is associated with significant mortality, morbidity and increased length of hospital stay.To improve clinical outcomes of AKI by early detection and timely referral to the renal,the investigators developed an electronic alert system which identifies all cases of AKI occurring in patients over 18 years.The system was also designed to collect data on AKI incidence one of the biggest tertiary hospital in China.

A prospective, randomly controlled cohort study will be conducted agmong the patients with AKI who are detected by the use of AKI sniffer. The investigators chose to assess all inpatient serum creatinine results using a combination of "KDIGO" criteria.

The investigators randomly divided the patients into two groups:

1. Usual care : patients will receive standard clinical care by the primary physicians
2. AKI alert : an AKI alert will be sent to the the doctor in charge. Our team of kidney experts would give a suggestion if the the doctor in charge issue consultation applications.

Inclusion Criteria:

• adult patients with an Alert for AKI(based on KDIGO guidelines)

Exclusion Criteria:

• patients already on dialysis for AKI at the time of alert
• patients with End stage renal disease
• patients <18 years of age
• patients dissenting from participation according to the Ethics application