Dialyzing Wisely - Improving the Delivery of Acute Renal Replacement Therapy to Albertans

Recruiting

• Conditions: Acute Renal Injury
• Interventions: Other: KPI reports; Other: Prescriber reports

• Registration Number: NCT05186636
• Lead Sponsor: University of Alberta

Brief Summary

Implementation of an evidence-based and best practices acute RRT pathway aiming to decrease acute RRT program and healthcare systems costs while improving important patient-reported outcomes.

Detailed Description

Providing acute dialysis to critically ill patients in ICU settings is resource and cost intensive. The daily costs of acute dialysis can range from $528/day for intermittent hemodialysis to $865/day for continuous renal replacement therapy. Providing acute dialysis in ICU settings requires a specialized team of nurses, educators, physicians and stakeholders to ensure its safe and effective prescription and delivery. Acute dialysis is typically delivered to some of the most acutely ill patients admitted to the ICU to support organ function and sustain life.

At present, there is not a standardized approach to the prescription and delivery of acute dialysis therapy in ICUs across Alberta. The DIALYZING WISELY program will implement a standardized approach to the delivery of best practices for acute dialysis therapy to all patients who receive treatment across ICUs in Alberta.

Study Timeline

• Study First Submitted: 2021-12-09
• Study First Submitted QC: 2021-12-23
• Study First Posted: 2022-01-11
• Study Start: 2023-01-12
• Status Verified: 2025-02
• Last Update Submitted: 2025-02-03
• Last Update Posted: 2025-02-04
• Primary Completion: 2025-11-30
• Study Completion: 2026-06-30

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 4500

Inclusion Criteria

Patient in one of 15 adult and 3 pediatric intensive care units in Alberta Receive acute RRT as part of their usual clinical care during the intervention period

Exclusion Criteria

• none

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
ICU patients receiving renal replacement therapy	Prescriber reports	All patients in participating ICU's receiving CRRT or IRRT during the study period
ICU patients receiving renal replacement therapy	KPI reports	All patients in participating ICU's receiving CRRT or IRRT during the study period

Primary Outcome Measures

Name	Time	Method
Health system costs	3 years	Acute RRT and healthcare systems costs
Key performance indicators (KPI)	Throughout intervention period up to 3 years	Changes in acute KPIs

Secondary Outcome Measures

Name	Time	Method
ICU and 90 day mortality	3 years	number of patients who die before ICU discharge or within 90 days of ICU stay
Length of renal replacement therapy	3 years	Length of time patient receives RRT during their ICU stay
Rates of RRT dependence at 90 days	3 years	number of patients who are receiving RRT at 90 days after ICU stay
ICU and hospital lengths of stay	3 years	Number of days patient spends in the ICU and hospital

Trial Locations

Locations (15)

Rockyview General Hospital; 🇨🇦 Calgary, Alberta, Canada

Alberta Children's Hospital; 🇨🇦 Calgary, Alberta, Canada

South Health Campus; 🇨🇦 CAlgary, Alberta, Canada

Royal Alexandra Hospital; 🇨🇦 Edmonton, Alberta, Canada

Misericordia Community Hospital; 🇨🇦 Edmonton, Alberta, Canada

Manzankowski Alberta Heart Institute; 🇨🇦 Edmonton, Alberta, Canada

Stollery Children's Hospital; 🇨🇦 Edmonton, Alberta, Canada

Grey Nuns Community Hospital; 🇨🇦 Edmonton, Alberta, Canada

Grande Prairie Regional Hospital; 🇨🇦 Grande Prairie, Alberta, Canada

Chinook Regional Hospital; 🇨🇦 Lethbridge, Alberta, Canada

Peter Lougheed Centre; 🇨🇦 Calgary, Alberta, Canada

Foothills Medical Centre; 🇨🇦 Calgary, Alberta, Canada

University of Alberta Hospital; 🇨🇦 Edmonton, Alberta, Canada

Red Deer Regional Hospital Centre; 🇨🇦 Red Deer, Alberta, Canada

Sturgeon Community Hospital; 🇨🇦 St. Albert, Alberta, Canada