AKI, AKI - Acute Kidney Injury, Dialysis Patients
Conditions
Brief summary
Providing additional information to patients with acute kidney injury who continue dialysis after hospital discharge and to the accepting kidney doctor (nephrologist) who manages their dialysis may be feasible and beneficial. This study will pilot measuring the patient's residual kidney function at the time of discharge and communicating that result to the accepting nephrologist and the patient, along with information on recommended recovery monitoring frequency and criteria for consideration of a twice-weekly hemodialysis schedule.
Interventions
BEHAVIORALTransmission of additional AKI-D recovery information
Measuring residual kidney function at the time of hospital discharge by timed urine collection (6-24 hours in duration), transmitting the results (urine volume, urea clearance, and creatinine clearance) to the accepting nephrologist and to the patient, along with information on recommended recovery monitoring frequency and criteria for consideration of a twice-weekly hemodialysis schedule.
OTHERNo additional AKI-D recovery information
The same timed urine collection will be collected at the time of hospital discharge as in the intervention arm, but in the control arm the results will not be transmitted to the accepting nephrologist or to the patient and no information on recommended recovery monitoring frequency and criteria for consideration of a twice-weekly hemodialysis schedule will be transmitted. Instead, the research team will call the accepting nephrologist to alert them that this is an AKI-D patient that is being followed by the research team for recovery for up to 60 days.
Sponsors
University of California, San Francisco
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* AKI-D (not ESKD, as determined by the clinical inpatient nephrology team) * Age ≥ 18 years * Planned for continued dialysis outside the acute hospital setting (at outpatient dialysis unit/SNF/LTACH, not planned transfer to another short-stay acute care hospital).
Exclusion criteria
* Pregnant * Prisoner * Unable to consent and no surrogate decision maker available * Clinical team declines to allow approach for study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Feasibility: The proportion of patients who complete the timed urine collection within seven days before discharge and are able to have the results successfully transmitted to the accepting nephrologist and patient. | Baseline |
Secondary
| Measure | Time frame |
|---|---|
| Recruitment rate: Number of patients enrolled per month | Total study duration, anticipated 2 years |
| Number of post-discharge urine collections completed | Study day 60 |
| Proportion prescribed a <3x/wk hemodialysis schedule at any time within 60 days of hospital discharge | Study day 60 |
| Proportion who recover from needing dialysis | Study day 60 |
| Proportion who trial a <3x/wk hemodialysis schedule but subsequently need to be increased to >= 3x/wk during the 60-day follow-up. | Study day 60 |
| Screening-to-recruitment ratio: Number of patients who meet inclusion criteria divided by the number of patients enrolled. | Total study duration, anticipated 2 years |
| Incidence of adverse events | Study day 60 |
Countries
United States
Contacts
CONTACTIan E McCoy, MD, MS
PRINCIPAL_INVESTIGATORIan E McCoy, MD, MS
University of California, San Francisco
Outcome results
None listed