Using CPAP to Prevent Acute Kidney Injury in Hospitalized Patients With Chronic Kidney Disease
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 试验地点
- 2
- 主要终点
- Incidence of acute kidney injury
研究概览
简要总结
Obstructive sleep apnea (OSA) is a common and undertreated condition in patients with chronic kidney disease (CKD). Both physiologic and empiric data suggest that renal hypoxia due to OSA is associated with worsening kidney function. Hospitalized patients are often exposed to multiple nephrotoxins such as antibiotics, contrast agents, and diuretics, which place them at risk for acute worsening of kidney function. This study aims to determine whether immediate diagnosis and treatment of OSA in CKD patients will decrease the incidence of acute kidney injury during hospitalization. The investigators will evaluate the extent to which this effect can be attributed to a decrease in nocturnal hypoxia and improved blood pressure control. Secondary endpoints include hospital length of stay, and a composite outcome comprised of hemodialysis initiation, major cardiovascular events, and mortality.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 19 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •CKD defined by National Kidney Foundation Staging system: eGFR < 60
- •Overnight sleep study consistent with OSA
排除标准
- •Currently treated with positive airway pressure for sleep-disordered breathing
- •Hemodynamically unstable, defined as SBP < 90, or use of vasopressors
- •Intubated or mechanically ventilated
- •Respiratory insufficiency, defined as P/F ratio < 250, or requiring mechanical ventilation
- •End stage renal disease on renal replacement therapy
- •Contraindication to CPAP, including active emesis, recent intracranial surgery, altered level of consciousness
结局指标
主要结局
Incidence of acute kidney injury
时间窗: participants will be followed for the duration of hospital stay, an expected average of 5 days
incidence of acute kidney injury during hospitalization (defined as an increase in creatinine by 0.5 mg/dl or more)
次要结局
- Nocturnal hypoxia(participants will be followed for the duration of hospital stay, an expected average of 5 days)
- composite outcome(participants will be followed for the duration of hospital stay, an expected average of 5 days)
- Hospital length of stay(participants will be followed for the duration of hospital stay, an expected average of 5 days)
- Blood pressure control(participants will be followed for the duration of hospital stay, an expected average of 5 days)