Personalized hydration strategy for Acute Kidney Injury
This study is evaluating whether a new hydration strategy can prevent CI-AKI in patients undergoing coronary angiogram and/or PCI.
See full descriptionAbout the trial for Acute Kidney Injury
Treatment Groups
This trial involves 2 different treatments. Personalized Hydration Strategy is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.
Eligibility
This trial is for patients born any sex aged 18 and older. There are 4 eligibility criteria to participate in this trial as listed below.
Approximate Timelines
Measurement Requirements
This trial is evaluating whether Personalized hydration strategy will improve 1 primary outcome and 9 secondary outcomes in patients with Acute Kidney Injury. Measurement will happen over the course of 7 days.
Who is running the study
Principal InvestigatorPatient Q & A Section
What are common treatments for acute kidney injury?
Results from a recent clinical trial reinforces the need for the early identification and treatment of AKI for improving patient outcomes. In patients with AKI, the administration of hydration alone does not improve outcomes but is useful for lowering body fluid and electrolytes. Antibiotics did not result in improvement in renal outcome or shorter LOS. There were significant correlations between lower admission serum sodium and positive clinical outcomes.
What is acute kidney injury?
AKI incidence is similar in critically injured patients and medical ICU patients. Risk factors include sepsis, age ≥ 60 years, high serum creatinine and BUN, and increased CCI. AKI is an independent predictor of mortality. Treatment of patients with AKI in the hospital and outside the hospital (e.g. in the emergency department - ED) is recommended, since there is a much worse prognosis.
How many people get acute kidney injury a year in the United States?
The incidence of AKI in hospitalized pediatric patients increases with increasing age. The majority of pediatric AKI is the result of underlying chronic disease and the number of hospitalizations associated with AKI increases.
Can acute kidney injury be cured?
AKI is a complex condition with a diverse range of treatments and prognoses. Early recognition and correction of electrolyte imbalances with effective and prompt use of renal replacement therapy are critical in achieving good outcomes.
What are the signs of acute kidney injury?
A serum creatinine of 1.5 mg/dL or greater is indicative of acute kidney injury, and a urinary output of less than 0.5 mL/h is predictive of its subsequent deterioration. A serum lactate of>2.0 mmol/L with no improvement after 24 hours of correction with intravenous infusion is an ominous sign because a decrease in renal perfusion occurs within a day in that setting. In a nondiabetic patient with acute kidney injury and a urinary out of 0.9 mL/h, a serum creatinine level of 0.7 mg/dL or greater is associated with a 30% risk of in-hospital death.
What causes acute kidney injury?
There are many triggers that can cause AKI in the critically ill patient. These causes vary by patient and often have little effect on survival or renal recovery. The most obvious cause of AKI is AKI caused by nephrotoxic effects of dialysis, although this is also likely the case in chronic AKI, in which a direct injury (such as from injury) causes injury to the proximal tubule. AKI may have multiple etiologies and multiple manifestations. Understanding of these etiologies is critical to identifying appropriate therapies.
How does personalized hydration strategy work?
In critically ill patients with renal dysfunction, hydration strategy based on baseline and serial hydration measurements enables prediction of fluid responsiveness with a high degree of accuracy. Monitoring BUN and creatinine levels and urine output are indispensable components of this algorithm.
Does personalized hydration strategy improve quality of life for those with acute kidney injury?
This exploratory analysis shows that patients with AKI have a decreased quality of life with no improvement after personalized hydration. The study suggests these patients should be better served with less intensive interventions.
Is personalized hydration strategy safe for people?
Data from a recent study showed the feasibility of this personalized hydration strategy and recommended a personalized hydration strategy as a safe strategy to reduce fluid overload for patients on CAPD.
What are the latest developments in personalized hydration strategy for therapeutic use?
Hydration interventions to reduce sodium and volume loading, as well as the timing for initiating intervention, were found to have little positive effect on fluid overload or mortality in patients with acute kidney injury.
Is personalized hydration strategy typically used in combination with any other treatments?
The use of an hydration strategy tailored to a given patient is an increasingly common adjunct to the use of other treatment modalities when the goal of therapeutic care is to optimize patient outcome.
Who should consider clinical trials for acute kidney injury?
The evidence supporting the use of RASI and corticosteroids in the management of acute kidney injury is weak. There has been interest in the use of RASI in an attempt to halt further kidney damage but studies have been too inconsistent to show any convincing evidence for the efficacy or safety of these agents. However, we can assume that, despite their inconclusive evidence, they are not completely useless but we cannot and cannot be confident of their benefit. Clinical trials will be crucial for determining the most appropriate management for patients with AKI.