a study to support the development of the enhanced fluid assessment tool for patients with acute kidney injury

Conditions: Acute Kidney Injury

Summary: acute kidney injury (aki) is the sudden and recent reduction in kidney function. this can be detected by measuring a rise in blood creatinine level or from a reduction in urine. reasons for developing aki, include dehydration, low blood pressure, medication and infection. when the kidneys stop working, there can be a build-up of toxins and fluid. it is extremely important to identify a patient's fluid status as too little can cause further damage to the kidneys and too much can be harmful. assessment is varied and often inaccurate and there needs to be a standard approach to fluid assessment.

acute kidney injury (aki) is the sudden and recent reduction in kidney function. this can be detected by measuring a rise in blood creatinine level or from a reduction in urine. reasons for developing aki, include dehydration, low blood pressure, medication and infection. when the kidneys stop working, there can be a build-up of toxins and fluid. it is extremely important to identify a patient's fluid status as too little can cause further damage to the kidneys and too much can be harmful. assessment is varied and often inaccurate and there needs to be a standard approach to fluid assessment. aim: to develop an enhanced fluid assessment tool for patients with aki. workstream 1: aim: to identify what methods are useful to assess fluid in a patient with aki. the fluid assessment techniques that are useful and are used, bioimpedance and patient reported signs and symptoms. workstream 2: aim: to identify the best methods of determining fluid status in a patient with aki the findings from workstream 1 will be used to rank the most useful fluid assessment techniques. this will lead to the development of the enhanced fluid assessment tool. workstream 3: aim: to assess if the tool is practical and clinically useful in determining a patient's fluid status. the terminology and language will be reviewed and the tool will be used to assess patients and to determine the patients fluid status.

Eligibility criteria:
inclusion criteria: * workstream 1 and 3 (phase 3): patients who will be included in the study will be adult patients (over 18 years old) identified as having an acute kidney injury (aki) within 72 hours of admission to hospital. workstream 2: experts in fluid assessment (doctors, nurses and ahps). persons included will be experts in their field of practice and have a recognised expertise in fluid assessment. workstream 3: phase 1: experts in fluid assessment (doctors, nurses and ahps). phase 2: staff nurses currently working on a clinical ward. exclusion criteria: * patients who have kidney failure requiring dialysis or who are being conservatively managed. * patients who are receiving end of life (eol) care. * patients who have a pacemaker as this interferes with bioimpedance (ws1+3). * there is no baseline creatinine. * the patient has acquired an aki 72 hours after admission to hospital. * the patient has acute coronary syndrome

Keywords: dehydration hypotension acute kidney injury hypovolaemia respiratory rate extracellular fluid hypertension body weight changes pulmonary oedema oedema signs and symptoms blood volume