Predictors of Acute Kidney Injury in Patients With Acute Decompensated Heart Failure in Emergency
- Conditions
- Acute Kidney InjuryAcute Heart Failure
- Interventions
- Diagnostic Test: Serum Creatinine
- Registration Number
- NCT06463964
- Lead Sponsor
- Sohag University
- Brief Summary
Acute Decompensated Heart Failure ADHF is one of the leading causes of hospitalization. ADHF is a growing global health problem affecting more than 26 million individuals worldwide Acute Kidney Injury AKI is a common event in the natural disease history of patients with Heart Failure HF, The clinical importance of the co-existence of acute cardiac and renal dysfunction, known as acute cardiorenal syndrome CRS, and its management have recieved great attention recently Various studies have employed different criteria to define and calssify AKI. According to Risk, Injury, and Failure; and Loss, and End-stage kidney disease RIFLE criteria formulated by the Acute Dialyisis Quality Initiative ADQI AKI can be divided into five stages; renal injury risk, renal impairment, renal failure, renal function loss, and end stage kidney disease
- Detailed Description
In the past few years, investigators have reported that AHF patients might experience "congestion", named to describe signs and symptoms of extracellular fluid accumulation that results in increased cardiac filling pressure. This triggers compensatory mechanisms such as the renin-angiotensin-aldosterone system, sympathetic nervous system, and other local mediators. These compensatory mechanisms interact to maintain fluid volume and "renal congestion" has been recognized as part of systemic congestion. Renal congestion, resulting from lower cardiac output, tubule glomerular feedback, increased intra-abdominal pressure and increased venous pressure, has been viewed as a contributor to renal function impairment in ADHF.
Most patients with acute CRS are treated in the emergency department ED. The findings provide important insight into the present situation of patients with ADHF who develop AKI in an emergency setting.
The current diagnostic paradigm for AKI relies largely on biomarkers of renal function (serum creatinine and urine output) that have been in clinical use for over 50 years but are known to be insensitive and slow to change after kidney injury . It is very important to detect kidney damage in the preclinical process with new diagnostic methods and thus to provide early intervention in AKI.
Changing AKI definition and classification by year, these existing prediction models also vary by population, region, sample size and research methods. However, many studies have found a high incidence of AKI and a large impact on outcomes in ADHF patients, data pooled from these studies are inadequate. So, we will conduct this study to evaluate predictors of AKI in patients with ADHF in emergency departments.
Recruitment & Eligibility
- Status
- ENROLLING_BY_INVITATION
- Sex
- All
- Target Recruitment
- 100
- Aged >18 Yrs Both Sexes Patients with ADHF
- Patients udnergoing maintenance renal replacment therapy (RRT) such as hemodialysis and peritoneal dialysis History of CKD Kdiney transplantation Undergoing opeartions within 1 week before and after AKI events Drug Toxicity Rheumatologic or auto immune disease Acute infection Diretic therapy of radio-opaque contrast media in the last 15 days History of aminoglycosides, metformin and nonsteroid anti inflammatory drugs in the last 7 days Thyroid dysfunction
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Group II Serum Creatinine (Patients with new (de novo ) ADHF) Group I Serum Creatinine ( Patients with worsening ADHF)
- Primary Outcome Measures
Name Time Method Change in serum creatinine in mg/dL in patients with acute decompensated heart failure in ER 6 months Change in serum creatinine in patients with acute decompensated heart failure in ER
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Sohag university Hospital
🇪🇬Sohag, Egypt