Referral Patterns for Hospital Acquired Acute Kidney Injury and Relevance to Renal Outcomes

Study Overview
=================
Brief Summary
-----------------
Few studies analyzed the referral time to nephrologists and its impact on the patient outcome in a large cohort. The investigators described the incidence and determined the outcome with respect to renal function recovery, renal replacement therapy (RRT) requirement and in-hospital mortality of Hospital Acquired Acute Kidney Injury (HA-AKI) without nephrology referral (nrHA-AKI) and late referred HA-AKI patients to nephrologists (lrHA-AKI) compared with early referral patients (erHA-AKI). The patients included were admitted to the tertiary care academic center of Lausanne (Switzerland) between 2004 and 2008, in the medical and surgical services and in the intensive care unit (ICU).

Official Title
-----------------
Referral Patterns for Hospital Acquired Acute Kidney Injury and Relevance to Renal Outcomes

Conditions
-----------------
Renal Replacement Therapy, Mortality

Intervention / Treatment
-----------------
* Other: Nephrologist referral


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Adult patients. Hospitalization in the medicine and surgery wards and in the intensive care unit. Hospitalized patients with acquired acute kidney injury according to the Acute Kidney Injury Network (AKIN)criteria. HA-AKI patients with no referral to the nephrologist (nrHA-AKI). HA-AKI patients referred late (more than five days [> 5 days]) to the nephrologist (lrHA-AKI). HA-AKI patients early referred (within five days after sCr increase) to the nephrologist (erHA-AKI). Exclusion Criteria: Patients with AKI at the time of the hospital admission and during the first 48 hours after admission. Patients hospitalized in other wards. Children under 18.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| nrHA-AKI patients<br>Patients with hospital-acquired acute kidney injury not referred to the nephrologists | Other: Nephrologist referral<br>* Nephrologist specialty, renal replacement therapy<br>* Other names: Control group: early-referred patients with HA-AKI.;|
| lrHA-AKI patients<br>Patients with hospital-acquired acute kidney injury whao are late referred to the nephrologists | Other: Nephrologist referral<br>* Nephrologist specialty, renal replacement therapy<br>* Other names: Control group: early-referred patients with HA-AKI.;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Referral patterns for hospital acquired acute kidney injury and relevance to renal outcomes | Recovery of renal function during hospital stay. Requirement for renal replacement therapy. |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Referral patterns for hospital acquired acute kidney injury and relevance to renal outcomes | Length of hospital stay. In-hospital mortality. |  | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
No referral, Late referral, Acute kidney injury, Intensive care unit, In-hospital mortality, Renal outcome, Requirement for renal replacement therapy, Length of hospital stay, Impact, Incidence