Acute Kidney Injury, Cardiac Dysfunction, Cardiovascular Prognosis, Uremic; Toxemia, Vascular Dysfunction
Conditions
Keywords
Acute Kidney Injury, Uremic; Toxemia, vascular dysfunction, cardiac dysfunction, cardiovascular prognosis
Brief summary
Acute kidney injury (AKI) is a frequent disease in conventional hospital departments and in intensive care units. It's associated with a high risk to develop chronic kidney disease (CKD), even after a single small AKI episode. It's also associated with an important morbi-mortality, particularly cardiovascular (CV). Some studies have already showed a link between AKI and CV risk but pathologic mechanisms implicated are still unknown. In AKI and CKD, numerous substances, called uremic toxins (UT) are accumulating in blood. In CKD, those toxins, and particularly Indoxyl sulfate (IS), are known to have cardiac and vascular deleterious consequences. However, in AKI, whether acute accumulation of UT may trigger CV complications is unknown. The purpose of this study is that during AKI, a high UT concentration, in particular IS, would be associated with early vascular and cardiac dysfunctions that can be characterized by the persistence of an accelerated pulse wave velocity (PWV). The main objective is to evaluate the correlation between UT concentrations (especially IS) and arterial stiffness (PWV measurement) at three months of an AKI episode in conventional hospital departments and in the intensive care unit of nephrology.
Interventions
OTHERblood sample
Blood sample withdrawal will be done and serum creatinine, IS, PCS, FGF-23, Angiopoietin-2, VCAM-1, E-Selectin and Troponin will be measured.
Sponsors
Centre Hospitalier Universitaire, Amiens
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age over 18 years old. * Patients hospitalized in conventional hospital departments and in intensive care units of nephrology. * Patients with moderate to severe AKI (KDIGO 2 or 3) without dialysis. * AKI from functional or organic aetiology
Exclusion criteria
* Patients with severe CKD (GFR\<45ml/min/1.73 m2) or with kidney transplants. * Patients with AKI from septic or obstructive aetiology. * Patients with AKI from toxic aetiology whose toxic would be also responsable of cardia toxicity. * Patients with sepsis or blood inflammation. * Patients with severe chronic cardia dysfunction. * Patients with arrhythmia or complete heart block. * Patients with peripheral artery occlusive disease. * Pregnancy. * Patients on palliative care.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change of pulse wave velocity (PWV) measurement from baseline | at 3 months |
Secondary
| Measure | Time frame |
|---|---|
| Correlation between Para-cresyl Sulfate (PCS) concentration and PWV | 3 months |
| Correlation between Fibroblast Growth Factor 23 (FGF23) concentration and arterial pressure measurement | 3 months |
| Correlation between Fibroblast Growth Factor 23 (FGF23) concentration and cardiac diastolic function | 3 months |
| Correlation between Fibroblast Growth Factor 23 (FGF23) concentration and PWV | 3 months |
| Correlation between IS concentration and cardiac diastolic function | 3 months |
| Correlation between Para-cresyl Sulfate (PCS) concentration and arterial pressure measurement | 3 months |
| Correlation between Para-cresyl Sulfate (PCS) concentration and cardiac diastolic function | 3 months |
| Correlation between IS concentration and arterial pressure measurement | 3 months |
Countries
France
Contacts
Primary ContactPauline Caillard, MD
Outcome results
None listed