Acute Kidney Injury
Conditions
Keywords
acute kidney injury, hemodynamic stabilisation, nephrotoxic medication
Brief summary
Postoperative acute kidney injury (AKI) refers to increased mortality and morbidity in patients after non-cardiac surgery. The Kidney Disease Improving Global Outcomes (KDIGO)-guidelines recommend a bundle of procedures to prevent the occurrence of AKI: A protocol for the improvement of the hemodynamic situation and a standardized proceeding in hemodynamic monitoring, consequent avoidance of nephrotoxic substances, regular measurement of creatinine and urine output, as well as normoglycemia. The primary goal is to determine if the consequent application of the KDIGO-bundle leads to a prevention of the occurrence of AKI in patients at risk after non-cardiac surgery.
Detailed description
All patients included in the study will be treated with the KDIGO-bundle (hemodynamic stabilization, avoidance of nephrotoxic substances, normoglycemia and measurement of creatinine in serum and urine output). 12 h, 24h as well as on day 2, 3, 5 and 10 after admission on ICU the occurence of AKI (according to KDIGO) will be assessed.
Interventions
PROCEDUREkidney treatment bundle (KDIGO)
Application of the measures of the kidney treatment bundle.
Sponsors
Wuerzburg University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age \> 65 years * chronic kidney disease * diabetes mellitus, chronic heart, lung or liver disease * hemodynamic instability (intra and/or post-operative) * trauma, burn injury, major surgery, usage of x-ray contrast and sepsis.
Exclusion criteria
* Age \< 18 years * pregnancy * kidney graft recipient * chronic renal disease with or without renal replacement therapy and cardiac surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of postoperative AKI | until day 5 after surgery | AKI according to KDIGO definition |
Secondary
| Measure | Time frame |
|---|---|
| hospital mortality | up to 100 days after surgery |
| usage of renal replacement therapy (hours) | up to 30 days after surgery |
| length of invasive respirator therapy (hours) | up to 30 days after surgery |
| Intensive care unit mortality | 28 days and 90 days after surgery |
| urine output (total ml) | after 12 hours, on day 2 (in 24hour), 3 (in 24hour), 5 (in 24hour) and 10 (in 24hour) after surgery |
| length of hospital stay | up to 100 days after surgery |
| length of ICU stay | up to 100 days after surgery |
| creatinine in serum | 12 hours, day 2, 3, 5 and 10 after surgery |
Countries
Germany
Outcome results
None listed