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Acute Kidney Injury - Epidemiology in Intensive Care Unit Patients 2: an International Multicenter Cohort Study

Conditions
Kidney Injury, Acute
Intensive Care Unit ICU
Registration Number
NCT07207031
Lead Sponsor
University Hospital, Ghent
Brief Summary

The goal of this observational study is to learn the epidemiology and outcomes of acute kidney injury in critically ill adult patients admited to the intensive care unit (ICU). The main questions it aims to answer are:To provide a contemporary update on the epidemiology (rates, severity, duration, and etiology) of acute kidney injury and associated outcomes in critically ill patients.

The co-primary outcomes are:

* occurrence rate of acute kidney injury within 7 days of ICU admission

* maximum severity of acute kidney injury within 7 days of ICU admission.

Secondary outcomes:

* Proportion of acute kidney injury in patients with and without known baseline serum creatinine

* Duration of acute kidney injury episodes (within first week of ICU admission)

* Proportion of episodes with rapid reversal (duration \<48h) versus persistent acute kidney injury (duration ≥48h)

* Incidence of acute kidney disease at ICU discharge and hospital discharge, truncated at 90-d

* Use of Renal Replacement Therapy within 7 days of ICU admission

* Type and specifics of applied Renal Replacement Therapy (indications, timing, modality, method duration, anticoagulation, discontinuation)

* ICU lenght of stay (ICU LOS), Hospital lenght of stay (Hospital LOS)

* ICU readmission up to day 90

* Hospital readmission up to day 90

* Serum creatinine level at ICU and hospital discharge (truncated at day 90)

* RRT dependence at hospital discharge (any RRT applied within 72 hours of discharge)

* Mortality at hospital discharge (truncated at 90-d)

* Magnitude of acute kidney injury: area under the curve of acute kidney injury severity over time

* Incidence of acute kidney injury and maximum acute kidney injury severity stage defined by serum creatinine and/or urine output criteria only, within 7 days of ICU admission.

Additional endpoints for patients included in the "long term outcomes substudy":

* Serum creatinine level at day 90, and 1 y

* Renal Replacement Therapy dependence at day 90, and 1y

* Mortality at hospital discharge at day 90, and 1y

* Survival analysis up to day 90 and 1 y

* Health-related quality of life at day 90 and 1y

* Major Adverse Kidney Events (MAKE): a composite endpoint of death, use of Renal Replacement Therapy and decreased kidney function at day 90, and 1 year.

Detailed Description

Not available

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
10642
Inclusion Criteria
  • Age >=18 y
  • Admitted to a participating ICU.
  • Admitted to the ICU for more than 24-h, or anticipated length of stay in the ICU for 24-h or more.
  • Informed Consent according to local ethical committee
Exclusion Criteria
  • End Stage Kidney Disease treated with maintenance renal replacement therapy
  • Readmission to the ICU during same hospitalization episode
  • Missing acute kidney injury defining data (no measured serum creatinine and <6 hours of documented urinary output)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
occurrence rate of acute kidney injurywithin 7 days of ICU admission

occurrence rate of acute kidney injury in adult patients admitted to the ICU and defined by the Kidney Disease: Improving Global Outcomes defintion

maximum severity of acute kidney injurywithin 7 days of ICU admission.

maximum severity of acute kidney injury defined by the Kidney Disease: Improving Global Outcomes classification

Secondary Outcome Measures
NameTimeMethod
Proportion of acute kidney injury in patients with and without known baseline serum creatininewithin 7 days of ICU admission.

acute kidney injury as defined by the Kidney Disease: Improving Global Outcomes definition in patients with known baseline serum creatinine and in those without known baseline serum creatinine

Duration of acute kidney injury episodeswithin 7 days of ICU admission.

acute kidney injury defined by the Kidney Disease: Improving Global Outcomes definition, and duration measured in days

Proportion of episodes with rapid reversal (duration <48h) and persistent acute kidney injury(duration ≥48h)within 7 days of ICU admission.

acute kidney injury defined by the Kidney Disease: Improving Global Outcomes definition

Incidence of acute kidney diseaseat ICU discharge and at hospital discharge, or at 90-days in case hospital admission is longer than 90 days.

acute kidney disease as defined by the Kidney Disease: Improving Global Outcomes definition

Use of renal replacement therapy within 7 days of ICU admissionwithin 7 days of ICU admission.
Type and specifics of applied renal replacement therapywithin 7 days of ICU admission.

indications, timing, modality, method duration, anticoagulation, discontinuation

Hospital readmission up to day 90within 90 days of ICU admission
Length of stayhospital stay

Length of stay in the ICU, post ICU in the hospital, and total length of stay in the hospital , measured in days

ICU readmission up to day 90within 90 days of ICU admission
Serum creatinine level at ICU and hospital discharge (truncated at day 90)at discharge of the ICU and of the hospital, or day 90 after ICU admission if hospital stay is longer than 90 days after ICU admission
Renal Replacement Therapy dependence at hospital dischargehospital discharge

Renal Replacement Therapy dependence is defined as the use of renal replacement therapy within 72-hours before hospital discharge

Mortalityat hospital discharge or at day 90 after ICU admission if hospital stay is longer than 90 days after ICU admission
Magnitude of acute kidney injurywithin 7 days of ICU admission.

Magnitude of acute kidney injury: defined as the area under the curve of acute kidney injury severity over time

Incidence of acute kidney injury and maximum acute kidney injury severity stage defined by serum creatinine criteria only and urine output criteria onlywithin 7 days of ICU admission.

acute kidney injury is defined and classified by the Kidney Disease: Improving Global Outcomes definition

Trial Locations

Locations (1)

Ghent University Hospital

🇧🇪

Ghent, Belgium

Ghent University Hospital
🇧🇪Ghent, Belgium

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