NCT03486184Unknown不适用
Postoperative Acute Kidney Injury in Patients Undergoing Prolonged Neurosurgical Operations
适应症
试验速览
- 阶段
- 不适用
- 入组人数
- 100
- 主要终点
- the occurrence of AKI
研究概览
简要总结
Postoperative Acute Kidney Injury in Patients Undergoing Prolonged Neurosurgical Operations
详细描述
- Postoperative acute kidney injury (AKI) is a highly prevalent and prognostically important complication in various surgical settings. Patients who developed postoperative AKI is independently associated with markedly increased morbidity, mortality1-8 and higher economic burden1.
- AKI was defined by an increase in serum creatinine (SCr) ≥ 0.3 mg/dl or by an increase in SCr ≥ 50% and/or by a decrease in urine output to 0.5 ml/kg/hour for 6 hours, in the first 48 hours after surgery.
- Patients who developed AKI had a higher total ICU costs, prolonged length of hospital and ICU stay, and longer duration of postoperative mechanical ventilation.
- AKI has been studied in different surgical procedures especially cardiac & abdominal surgeries.
- Kovacheva et al 2016 retrospective study included 1656 craniotomy patients from 1998 to 2011. The AKI used criteria was RIFLE (Risk, Injury, Failure, Loss of kidney function and End-Stage Renal Failure), they reported an incidence of 9.9% of postoperative AKI9.
- Deng et al 2017 also reported an incidence of AKI up to 13.5% in patients undergoing neurosurgical surgery within the first 7 days. It was associated with independent risk factors included intraoperative blood loss, postoperative reoperation, use of mannitol during operation, concentration of Cystatin-C; a biomarker protein detecting early kidney injury before creatinine changes and postoperative APACHE II score10.
- As the number of neurosurgical procedures has been increased worldwide and in our department as well with new types of prolonged neurosurgery e.g. Skull - Base - Major cerebrovascular beside major cranial tumor excision. It becomes a necessary to re-evaluate the incidence, factors behind AKI and outcome in such prolonged surgery.
- In 2002, The Acute Dialysis Quality Initiative (ADQI) was created with primary goal was to create a uniform, accepted definition of AKI; hence RIFLE criteria was born. RIFLE is an acronym of Risk, Injury, Failure, Loss of Kidney Function & End-Stage Kidney Failure.
- In 2004, The Acute Kidney Injury Network (AKIN) was formed. A report of the AKIN proposed the following criteria for AKI.
- The AKIN criteria differ from the RIFLE criteria in several ways. The RIFLE criteria are defined as changes within 7 days, while the AKIN criteria suggest using 48 hours. The AKIN classification includes less severe injury in the criteria and AKIN also avoids using the glomerular filtration rate as a marker in AKI, as there is no dependable way to measure glomerular filtration rate and estimated glomerular filtration rate are unreliable in AKI.
- Haase et al. 2009 in their comparative study between RIFLE and AKIN in cardiac surgery; found no difference between the AKI scores11.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •patients aged 18 years or older who will do prolonged neurosurgical procedure, duration of surgery more than 4 hours and ASA 1-2-3.
排除标准
- •refusal of consent, preexisting renal transplantation, preexisting nephrectomy, presence of AKI before neurosurgical procedure, operation less than 4 hours, patients aged under 18 years, pregnancy and ASA 4-5.
结局指标
主要结局
the occurrence of AKI
时间窗: 2 days
BY using AKIN criteria.
次要结局
未报告次要终点
研究者
Ali Maher Abdel Salam Ahmed
Resident
Assiut University
相似试验
已完成
不适用
Evaluation of Postoperative Acute Kidney Injury (AKI) Incidence and Risk Factors in Patients Underwent PneumonectomyComplication,PostoperativeAcute Kidney InjuryStatus PneumonectomyNCT05672238Ankara University166
已完成
不适用
Renal Failure Following Lung Transplantation in Cystic Fibrosis PatientsCystic FibrosisNCT05001841Policlinico Hospital85
尚未招募
不适用
The relationship between perioperative acute kidney injury and biomakers in robot-assisted laparoscopic prostatectomyProstate cancerJPRN-UMIN000025934Division of Anesthesiology and Critical Care Medicine, Tottori University100
Unknown
不适用
Postoperative Kidney Functions in Geriatric Major Gynecologic-Oncologic SurgeryGeriatricsAcute Renal InjuryGynecologic SurgeryNCT05308810Ankara City Hospital Bilkent150
已完成
不适用
Risk Factors for Acute Kidney Injury in Patients Undergoing ArthroplastyPostoperative Acute Kidney InjuryArthroplastyNCT06296108Ankara University911