Nephroprotective Measures in Critically Ill Patients With Moderate/Severe Acute Kidney Injury
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Nephroprotective measures.
- Кому может быть актуально
- Состояния в реестре: Acute Kidney Injury. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Австрия, Германия, Нидерланды
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Implementation of Nephroprotective Measures in Critically Ill Patients With Moderate/Severe Acute Kidney Injury (AKI) - an Observational Study
Обзор
This study investigates to which extent recommended nephroprotective measures are implemented in critically ill patients with moderate or severe acute kidney injury.
Подробное описание
Acute kidney injury (AKI) is a global problem affecting more than 10% of all hospitalized patients and up to 50% of critically ill patients, with survival related not only to the severity,1 but also to the duration of renal dysfunction.2 Recent evidence suggests that two-thirds of patients with AKI resolve their renal dysfunction within 3-7 days whereas those in whom renal dysfunctions persist have dramatically reduced survival over the following year.2 Persistence of AKI is of grave importance in that it increases an individual's risk of developing chronic kidney disease (CKD) which is a major cause of morbidity and mortality. This link between AKI and CKD has been established over the last decade3 and specific recommendations for the management of patients with AKI have been proposed in order to potentially influence this transition.4 To date, there are no specific pharmacological options for preventing or treating AKI, which is why new approaches and intensive efforts are urgently needed to reduce the occurrence of AKI. The Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guidelines recommend implementing a bundle of different supportive measures, which, in theory, should be initiated in all patients with AKI in order to prevent disease progression. However, clinical practice and recent studies have shown that the implementation of the KDIGO bundle is still not standard clinical practice despite the fact that evidence suggest clear effectiveness in the reduction of AKI rates.5-9 Poor implementation of nephroprotective measures presents a major missed opportunity to reduce AKI-related morbidity and mortality and to improve long-term outcomes. To investigate the extent to which nephroprotective measures are implemented in patients with AKI can reduce the occurrence of persistent surgical AKI, a multi-center prospective cohort study will be performed.
Вмешательства
- Процедура Nephroprotective measures
Due to the observational design of the study, no study specific interventions are performed. The treatment of the patients is completely guided by the responsible physicians.
Первичные конечные точки
- Rate of patients in whom "Kidney Disease: Improving Global Outcomes (KDIGO)" guideline recommendations are successfully implemented for 48 hours, following the onset of moderate/ severe AKI (defined by KDIGO criteria) [Срок оценки: 60 hours after onset of moderate/severe AKI]
Вторичные конечные точки (2)
- Severity of Acute Kidney Injury [Срок оценки: within 72 hours after diagnosis]
- Duration of AKI (Acute Kidney Injury) [Срок оценки: from onset of AKI until follow-up day 30]
Критерии участия
Критерии включения
- Critically ill patients with moderate or severe AKI (KDIGO stage 2 / 3)
- Requirement of vasopressors or mechanical ventilation
- Age ≥ 18 years
- Informed consent
Критерии исключения
- Chronic kidney disease (CKD) with a glomerular filtration rate < 20ml/min
- Chronic dialysis dependency
- History of renal transplantation
- Permanent ligation of the renal arteries
- AKI immediately following nephrectomy
- Patients requiring permanent administration of nephrotoxic drugs (e.g. immunosuppressive therapy afer liver transplantation)
- Persons with any kind of dependency on the investigator or employed by the sponsor or investigator.
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Дизайн исследования
- Модель наблюдения
- Когортное
Центры проведения
Австрия · 1 центр
- Universitätsklinik Innsbruck — Innsbruck
Германия · 1 центр
- University Hospital Münster; Department of Anesthesiology, Intensive Care Medicine and Pai — Münster
Нидерланды · 1 центр
- Radboud University medical cener — Nijmegen
Идентификаторы
NCT: NCT06472999 · AnIt23-10