Acute Kidney Injury
Conditions
Brief summary
This research is being done to develop materials and processes that will help facilitate education and kidney care coordination for AKI survivors.
Interventions
BEHAVIORALAKI in Care Transitions (ACT) program
Multicomponent transitional support bundle that includes consultation from nurse educators before discharge to deliver kidney health education and coordination of appointments post-discharge.
Sponsors
Agency for Healthcare Research and Quality (AHRQ)
Mayo Clinic
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
\- Participants will be recruited from those identified by a developed electronic health record list of patients with stage III AKI (severe) during a hospitalization based on serum creatinine rise or urine output decline from Olmsted County.
Exclusion criteria
* Dementia. * Non-English speaking. * Expected to be dismissed to a skilled nursing facility or hospice at discharge. * Expected to need dialysis at discharge. * Primary Care Transitions Program enrollment. * Transplant recipients within 100 days of transplant. * Can only have one time enrollment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Subjects to Complete the ACT Program | 30 days after hospitalization | Total number of subjects to complete the full ACT program intervention |
Countries
United States
Participant flow
Recruitment details
Eligible patients were identified using an electronic health record (EHR)- embedded list of adults (≥18 years) hospitalized at Mayo Clinic in Rochester from January 2022 to July 2023 who met stage 3 AKI criteria based on serum creatinine rise or urine output decline during a hospitalization and had a local address. Candidate participants were approached within 48-72 hours of discharge to obtain written informed consent and randomized 1:1 to the ACT intervention or usual care.
Participants by arm
| Arm | Count |
|---|---|
| AKI in Care Transitions (ACT) Group Subjects diagnosed with Acute Kidney Injury (AKI) during their hospital stay will participate in the ACT program which provides standardized education and assists with coordination of follow up care after hospital stay.
AKI in Care Transitions (ACT) program: Multicomponent transitional support bundle that includes consultation from nurse educators before discharge to deliver kidney health education and coordination of appointments post-discharge. | 25 |
| Usual Care Group Subjects diagnosed with Acute Kidney Injury (AKI) during their hospital stay will receive standard of care from their inpatient and outpatient care teams. | 25 |
| Total | 50 |
Baseline characteristics
| Characteristic | AKI in Care Transitions (ACT) Group | Usual Care Group | Total |
|---|---|---|---|
| Age, Continuous | 63 years | 66 years | 65 years |
| AKI Recovery stage at discharge Recovered (back to baseline) or stage 0 recovery (serum creatinine < 1.5x baseline) | 17 Participants | 13 Participants | 30 Participants |
| AKI Recovery stage at discharge Stage 1 recovery (1.5-1.9x baseline) | 3 Participants | 5 Participants | 8 Participants |
| AKI Recovery stage at discharge Stage 2 recovery (2.0-2.9x baseline) | 3 Participants | 3 Participants | 6 Participants |
| AKI Recovery stage at discharge Stage 3 recovery (3x baseline or >= 4 mg/dL) | 2 Participants | 4 Participants | 6 Participants |
| Discharge eGFR | 31 mL/min/1.73m^2 | 27 mL/min/1.73m^2 | 30 mL/min/1.73m^2 |
| Preadmission baseline eGFR | 63 mL/min/1.73m^2 | 61 mL/min/1.73m^2 | 62 mL/min/1.73m^2 |
| Race/Ethnicity, Customized Race/Ethnicity Non-Hispanic Caucasian | 23 Participants | 20 Participants | 43 Participants |
| Race/Ethnicity, Customized Race/Ethnicity Other or Unknown Race/Ethnicity | 2 Participants | 5 Participants | 7 Participants |
| Sex: Female, Male Female | 8 Participants | 7 Participants | 15 Participants |
| Sex: Female, Male Male | 17 Participants | 18 Participants | 35 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 1 / 25 | 1 / 25 |
| other Total, other adverse events | 0 / 25 | 0 / 25 |
| serious Total, serious adverse events | 0 / 25 | 0 / 25 |
Outcome results
Primary
Number of Subjects to Complete the ACT Program
Total number of subjects to complete the full ACT program intervention
Time frame: 30 days after hospitalization
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| AKI in Care Transitions (ACT) Group | Number of Subjects to Complete the ACT Program | 22 Participants |