Acute Kidney Injury, Cardiorenal Syndrome, Hospitalizations, Kidney Failure Chronic, Renal Replacement Therapies
Conditions
Keywords
Kidney injury, Renal function recovery, Dialysis initiation, Kidney biopsy, Cardiovascular complications, Nephrology care, Renal prognosis, Renal cohort, Kidney follow-up, Kidney disease progression
Brief summary
Acute Kidney Injury (AKI) is a common and serious condition in hospitalized patients, especially when it reaches stages 2 or 3 according to the KDIGO classification. These severe forms are associated with high mortality, a risk of progression to chronic kidney disease (CKD), and frequent cardiovascular complications. However, current data on how nephrologists manage these patients during hospitalization-and how these practices influence long-term outcomes-are limited and heterogeneous. The FAKIR study (French AKI Registry) is a prospective, multicenter, non-interventional observational study designed to describe the clinical management of patients admitted to nephrology departments for AKI stage 2 or 3 and to assess their renal and cardiovascular outcomes up to one year. The study hypothesizes that better characterization of in-hospital practices and patient trajectories will help identify predictors of renal recovery, progression to end-stage renal disease, and major cardiovascular events. Patients will be followed during hospitalization and at 3, 6, and 12 months to assess renal function, mortality, cardiovascular events, and rehospitalizations. This registry aims to provide real-life, multicenter data to support future guidelines and the development of structured post-AKI care pathways.
Interventions
None listed
Sponsors
University Hospital, Strasbourg, France
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years at admission * Hospitalized in a nephrology ward (standard or intensive nephrology care unit) * Diagnosis of acute kidney injury (AKI) stage 2 or 3 according to KDIGO criteria at the time of admission * Availability of follow-up data at 3 months (clinical or laboratory)
Exclusion criteria
* AKI stage 1 only * AKI acquired outside the nephrology department without subsequent transfer to nephrology * Hospitalized for another reason without documented AKI stage 2 or 3 * Refusal or opposition to data reuse for research purposes * Under legal protection (guardianship or trusteeship) without a representative to provide non-opposition * Incomplete medical records preventing collection of required baseline data
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of Complete Renal Recovery at 3 Months After Hospitalization for AKI KDIGO Stage 2 or 3 | Assessed at 3 months (±30 days) after admission for AKI in nephrology ward | Renal recovery is defined as a return of serum creatinine to ≤125% of the patient's baseline (pre-AKI) value, estimated using the CKD-EPI formula. Creatinine values are collected from medical records or follow-up labs performed at 3 months post-discharge. This outcome reflects the extent of renal function recovery following hospitalization for severe AKI and helps identify prognostic factors associated with favorable evolution. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| All-Cause Mortality at 12 Months After Hospitalization for AKI KDIGO Stage 2 or 3 | Assessed at 12 months post-admission (±30 days) | All-cause mortality is defined as the proportion of patients who die from any cause within 12 months following their admission for AKI KDIGO stage 2 or 3. Vital status is obtained from hospital records, follow-up contact, or national registries. This outcome will allow assessment of medium-term prognosis and identification of clinical factors associated with mortality in patients with severe AKI managed in nephrology units. |
| Incidence of Major Adverse Cardiovascular Events (MACE) at 12 Months | Assessed throughout the 12-month follow-up period | MACE includes non-fatal myocardial infarction, non-fatal stroke, hospitalization for acute heart failure, and cardiovascular death. Events will be identified from medical records, discharge summaries, and follow-up contacts. This outcome will assess the cardiovascular burden among patients with severe AKI managed in nephrology settings, and help determine the link between in-hospital management strategies and long-term cardiovascular risk. |
| Progression to End-Stage Renal Disease (ESRD) at 12 Months | Assessed at 12 months post-AKI hospitalization | ESRD is defined as the initiation of chronic renal replacement therapy (dialysis or kidney transplantation) or a sustained eGFR \<15 mL/min/1.73m². Data are collected through follow-up visits, patient contact, or hospital records. This measure evaluates long-term renal outcomes and identifies risk factors for irreversible kidney failure following AKI KDIGO stage 2 or 3. |
Contacts
Primary ContactMallaury Vervaeke
Outcome results
None listed