AKI - Acute Kidney Injury
Conditions
Keywords
AKI, sepsis, markers, urine sediment
Brief summary
The aim of the current study is to assess the predictive value of renal cell arrest biomarkers (urinary TIMP2 and IGFBP7), renal damage biomarkers (urinary KIM-1) and microscopic examination of urinary sediment in progression and outcome of sepsis associated AKI.
Detailed description
Acute kidney injury occurred in about 45-53% of patients with sepsis, and most septic AKI was mild or moderate AKI (KDIGO stage 1 or stage 2). However, previous study showed that up to 40% of these mild or moderate AKI would progress to more severe AKI (KDIGO stage 3), of which 30% required dialysis and the risk of death increased by 3-fold, as high as 70%. Therefore, early identifying patients at high risk for progressive AKI might help clinicians to enhance individualized monitoring and personalized management in patient with septic AKI, which might prevent or halt the ongoing renal injury and improve the outcome of patients with sepsis.
Interventions
DIAGNOSTIC_TESTrenal cell arrest and damage biomarkers assessment
measurement of TIMP2 and IGFBP7, KIM-1
Sponsors
Alexandria University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
The current study will include 80 patients with sepsis associated AKI stage 1 or 2 according to KDIGO definition admitted to Alexandria Main University Hospital. Urinary TIMP2 and IGFBP7: will be measured by the ELISA technique. Urinary KIM-1: will be measured by the ELISA technique. Examination of urine sediment from fresh urine sample.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* AKI stage 1 or 2 according to KDIGO definition. * Sepsis is defined based on the third international consensus definitions for sepsis and septic shock (Sepsis-3) as life threatening organ dysfunction caused by a dysregulated host response to infection. At least two of systemic inflammatory response syndrome (SIRS) criteria should be present
Exclusion criteria
* Age less than 18 years. * Patients with pre-existing chronic kidney disease (eGFR\<60 ml/min/1.73m2). * Previous renal replacement therapy. * Acute kidney injury caused by permanent postrenal obstruction. * Pregnancy. * Hepatorenal syndrome. * Renal transplant recipients. * Patients for whom survival to 30 days is unlikely due to end stage disease (end stage liver or heart disease or untreatable malignancy).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Urinary TIMP2 and IGFBP7 estimation | 90 days | both will be measured by the ELISA technique |
| Urinary KIM-1 estimation | 90 days | will be measured by the ELISA technique |
| Examination of urine sediment | 7 days | by calculating Perazella score |
| progression of AKI | 90 days | by assessing change in eGFR |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| need for renal replacement therapy | 90 days | need of any dialysis modality |
| mortality | 90 days | death |
| length of ICU and hospital stay | 90 days | duration of stay |
Countries
Egypt
Outcome results
None listed