None listed
Conditions
Brief summary
This study will investigate whether a simple urine test, the urinary albumin-to-creatinine ratio (uACR), can help identify intensive care unit (ICU) patients who are developing acute kidney injury (AKI) or whose kidney injury is likely to persist or worsen. Adults admitted to the ICU at Austin Hospital with AKI or at high risk for AKI will have urine samples collected at admission and again at 24 hours. These samples will be tested for uACR and compared with kidney outcomes during the hospital stay. The aim is to determine if uACR can improve early detection and risk stratification of AKI in critically ill patients. Findings may guide future studies and help improve kidney care in the ICU.
Interventions
Measurement of urinary albumin-to-creatinine ratio (uACR) in critically ill patients admitted to ICU at enrollment and again at 24 hours, with outcomes including development, progression, and persistence of acute kidney injury (AKI).
During weekday days, when patients are admitted to the ICU, the member of the investigating team will screen for eligibility and inclusion, as per the Figure below.
Suitable patients will be identified from intensive care unit in-patient lists. Patients who meet
Measurement of urinary albumin-to-creatinine ratio (uACR) in critically ill patients admitted to ICU at enrollment and again at 24 hours, with outcomes including development, progression, and persistence of acute kidney injury (AKI). During weekday days, when patients are admitted to the ICU, the member of the investigating team will screen for eligibility and inclusion, as per the Figure below. Suitable patients will be identified from intensive care unit in-patient lists. Patients who meet all the inclusion and none of the exclusion criteria will be enrolled in the study. For each eligible patient, the investigator will discuss with the attending physician and collect the first urine sample. A second urine sample will be collected 24 hours later. Urine sampling from the patient will be via existing indwelling urinary catheter and as per existing hospital policies for the collection/handling of biological samples.
Sponsors
Austin Health
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adults admitted to the Intensive Care Unit (ICU) of Austin Hospital. Age greater than or equal to 18 years Expected to remain in ICU for greater than 24 hours Either: • Acute kidney injury at enrolment (KDIGO criteria), or • High risk for AKI (modified ARBOC score =3: vasopressor use = 3 points; serum creatinine rise =1 µmol/L/h = 1 point; chronic liver disease = 1 point; urine output 3 hours = 1 point).
Exclusion criteria
End-stage renal disease requiring maintenance dialysis. Prior kidney transplantation. Baseline estimated glomerular filtration rate (eGFR) <30 mL/min/1.73m². Requirement for extracorporeal membrane oxygenation (ECMO). Known or suspected pregnancy. Treatment limitation orders (not for full active treatment). Absence of an indwelling urinary catheter.
Outcome results
None listed