Acute Kidney Injury
Conditions
Brief summary
Acute kidney injury increases the risk for chronic kidney disease, length of stay, readmissions and mortality. Currently the only way to diagnose acute kidney injury is with a serum creatinine or drop in urine output. Biomarkers for acute kidney injury are well elevated before rise in creatinine. Hypothesis is that by implementing an electronic alert system with an algorithm followed by remote ischemic preconditioning will prevent acute kidney injury.
Detailed description
The propose study is to incorporate an alert system in current medical health system and an algorithm will be used to activate clinicians and Nephrologist to confirm if patient is at high risk. Once identified as high risk the clinician and/or nephrologist will intervene and change current management if needed. First phase of study will look at an alert system and algorithm was enough to lower incidence of acute kidney injury. Phase 2 will also use alert system and algorithm that will be further randomized those that are identified as high risk for acute kidney injury to remote ischemic preconditioning.
Interventions
OTHERremote ischemic preconditioning
inflation and deflation of cuff 5min each cycle repeated 3 times
OTHERKDIGO guidelines
KDIGO stands for Kidney disease Improving global outcomes guidelines, and have guidelines for prevention and treatment of AKI which is considered standard of care.
Sponsors
Atlantic Health System
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Two part study: all patients will be triaged by alert system whether they are high risk for acute kidney injury and those patients that are identified as high risk for AKI have standard of care implemented by following kidney disease improving global outcomes guidelines in preventing AKI and part 2 will perform procedure called remote ischemic preconditioning in addition to standard of care in part1 in those patients that are identified as high risk for acute kidney injury.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* any admitted patients that are not excluded by
Exclusion criteria
* Patients who's creatinine returns to baseline after admitted can be included in study if patient still remains admitted.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| number of participants who developed acute kidney injury | during hospitalization, up to three months | development of acute kidney injury as measured by serum creatinine 1.5 times more then baseline |
| number of participants who required dialysis | during hospitalization, up to three months | need for initiation of dialysis after acute kidney injury develops during the admission |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| number of participants who receive dialysis | at time of admission when enrolled in study to 1 year post discharge | initiation of dialysis starting from at time of admission to 1 year post discharge |
| number of participants who are placed on hospice or have expired | at time of admission when enrolled in study to 1 year post discharge | death or placed on hospice |
| length of stay | during hospitalization, up to three months | starting from onset of acute kidney injury measured by elevated creatinine 1.5 times baseline creatinine to last day of discharged |
| number of participants who are readmitted | discharged from when enrolled in study to 1 year post discharge | readmissions to hospital within 1 year of first admission date |
| progression to chronic kidney disease | at time of admission when enrolled in study to 1 year post discharge | measured by serum creatinine over 1 year on followup labs |
Outcome results
None listed