Intensified Acute Kidney Disease Care to Reduce Chronic Kidney Disease
- Conditions
- Acute Kidney DiseaseAcute Kidney InjuryRenal Insufficiency, ChronicDecision Support Systems, Clinical
- Interventions
- Behavioral: Multidisciplinary team (MDT) care and Acute kidney disease (AKD) clinic
- Registration Number
- NCT04145609
- Lead Sponsor
- Taipei Medical University Shuang Ho Hospital
- Brief Summary
Strategies to stop AKI-AKD-CKD continuum - Policy is one of the collaborative projects, Strategies to stop AKI-AKD-CKD continuum, Epidemiology, Immunology, Repair, Artificial intelligence, and Policy (EIRAP). It is aimed to study effective interventional strategies that lower the incidence of CKD among patients with AKD. The intensified AKD care to reduce CKD (ISACC trial) is a prospective, open-labeled, randomized controlled trial is designed to evaluate the efficacy of multidisciplinary team care (MDT) model and acute kidney disease (AKD) clinic visits
- Detailed Description
Acute kidney disease (AKD), defined as the ongoing renal function impairment between 7 days and 90 days following AKI, has been proposed as a window of intervention to prevent the occurrence of CKD. However, the effective therapeutic strategies of AKD care remain to be developed. We intend to conduct a prospective, randomized, open-label, behavioral interventional trial to validate the efficacy of multidisciplinary team (MDT) care model which aims to improve AKD care and to reduce de novo CKD incidence.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 690
- Age ≥ 20 yrs
- Severe AKD: Stage 2, Stage 3 and Dialysis-requiring AKD (AKD-D)
- Pregnancy
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intensified care Multidisciplinary team (MDT) care and Acute kidney disease (AKD) clinic Experimental: Multidisciplinary team (MDT) care + Acute kidney disease (AKD) clinic Participants randomized to this arm will receive multidisciplinary team (MDT) care by a specialized medical team which is composed of nephrologist, pharmacist and dietitian. Besides intensified care, participants of this arm receive evaluation of biochemical and physiological renal function more frequently. In order to provide seamless care of this group, post-discharge acute kidney disease (AKD) clinic will also be arranged for them. Clinic visits consist of evaluation of renal function, reconciliation of medication and steering necessity of renal replacement therapy.
- Primary Outcome Measures
Name Time Method Proportion of Major adverse kidney event 90days Proportion of MAKE
* Renal progression to CKD
* Chronic dialysis (any 1 outpatient dialysis after discharge)
* Death
- Secondary Outcome Measures
Name Time Method Mortality 30days, 60days, 90days, 180days, 360 days, 3years Proportion of death
Proportion of MACE 30days, 60days, 90days, 180days, 360 days, 3years CVA, AMI, CHF, or cardiac revascularization procedure
Time to first ER visit 90days, 180days, 1year (360days) Time to first ER visit
Renal progression 90days, 180days, 360 days, 3years Proportion of renal progression to CKD
Time to first recurrence of AKI 90days, 180days, 1year (360days) Time to first recurrence of AKI
Time to MAKE 90days, 180days, 1year (360days) Time to MAKE
Time to death 90days, 180days, 1year (360days) Time to death
Time to chronic dialysis 90days, 180days, 1year (360days) Time to chronic dialysis
Time to renal progression to CKD 90days, 180days, 1year (360days) Time to renal progression to CKD
Time to first rehospitalization 90days, 180days, 1year (360days) Time to first rehospitalization
Chronic dialysis 90days, 180days, 360 days, 3years Proportion of chronic dialysis