Acute Kidney Injury, Sepsis, Shock, Trauma
Conditions
Keywords
Sepsis, Trauma, Shock, Acute kidney injury, Heparanase
Brief summary
Across the world, the most common cause of dying in the ICU is a disease called sepsis. Sepsis is a disease in which the body's protective response to infection becomes too intense, unnecessarily damaging important organs in the body. Kidney damage during sepsis is particularly bad, as a person's chance of survival drops significantly when he or she develops kidney failure. This study plans to learn more about how to detect (and thus prevent) kidney failure early in sepsis. The current tests doctors use only detect kidney failure once it's already happened. We must therefore find better ways of detecting kidney failure earlier, when there is still a chance to protect the kidneys. In this study, patients will provide a one-time sample of urine. We will check this urine for signs of a protein called heparanase, which we believe is important in early kidney failure. We will then see if high heparanase activity in urine predicts the risk of developing kidney failure. We will compare results from patients with sepsis with results from patients with trauma, allowing us to determine if heparanase is only important in sepsis kidney failure.
Interventions
OTHERUrine collection
Collection of 5 ml urine from urinary collection device (e.g. foley catheter).
Sponsors
Denver Health and Hospital Authority
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1\. Septic shock or major trauma. Septic shock will be defined by standard criteria including (a) the presence of the systemic inflammatory response syndrome (SIRS), (b) evidence of infection, and (c) treatment with vasopressor medications for \> 4 hours despite \> 30 ml/kg intravenous crystalloid resuscitation. As a critically-ill comparator group, we will also enroll adult patients admitted (within 24 hours prior to screening) to the Denver Health Surgical ICU with major trauma, as defined by an Injury Severity Score of \> 15.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acute kidney injury | 72 hours | Acute kidney injury will be determined using RIFLE criteria, based upon change in serum creatinine or urine output. |
Countries
United States
Outcome results
None listed