Clinical trial NCT03192189: Development of a Decision-making Aid for Referring Severe Kidney Injury Patients for Nephrology Consultations
Official title: Development of a Decision-making Aid for Referring Severe Kidney Injury Patients for Nephrology Consultations
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Chronic Kidney Diseases
Acute Kidney Injury
Lead sponsor: Centre Hospitalier Universitaire de Nīmes
Sponsor class: OTHER
First posted: 2017-06-20
Enrollment: 319
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients undergoing dialysis for acute kidney injury. All new adults (\>18 years old) hospitalized in a university center with severe AKI was included from August 2016 to December 2017. Inclusion criteria was a severe AKI defined by dialysis start for AKI or an increase of Scr upper 354 μmol/L. Exclusion criteria was CKD stage 5 , patients living with kidney transplant, plan dialysis for bilateral surgery nephrectomy, patient witch justice protection and refuse to participate. Eligible patients were identified by physicians for ICU and nephrology department and by laboratory biochemistry department for others wards. A Biochemistry alert system controlled the exhaustively of inclusion in ICU and Nephrology department during the period of the study.

Brief summary: Acute kidney injury is a frequent and growing complication associated with a risk of progressing into a chronic kidney disease. Recent guidelines have recommended systematic consultations with a nephrologist 3-6 months following hospitalization. Risk factors of developing chronic kidney disease between hospital visits are understudied.


Eligibility criteria: Inclusion Criteria:

* Age \>18 years
* Suffering from acute kidney injury treated with dialysis
* hospitalized in a university center from August 2016 to December 2017 with severe AKI defined according to 2 of the 3 criterion definitions of KDIGO stage AKI: an increase in SCr above 354 μmol/Lor renal replacement therapy (RRT) indication, but not the 3-fold increase in SCr increase within 7 days with SCr below 354 μmol/L.
* The patient has been informed and does not oppose the study
* The patient is insured or the beneficiary of a health insurance policy

Exclusion Criteria:

* The patients is under judicial protection or state guardianship
* Patient has chronic kidney disease(CKD) KDIGO stage 5
* It proves impossible to give the patient clear information
* patients living with kidney transplant
* plan dialysis for bilateral surgery nephrectomy
* patient refuse to participate and patients with no health insurance

Primary outcomes:
measure: Develop a prognostic score of progression to chronic kidney disease at 6 months in patients requiring hospitalization for dialysis for acute kidney injury to identify those who would benefit from consultation with a nephrologist
timeFrame: 6 months
Secondary outcomes:
measure: Identify new risk factors for progression to chronic kidney disease at 6 months post dialysis for acute kidney injury pre-hospitalization and during hospitalization and day of discharge
timeFrame: 6 months
measure: Identify renal phenotype of patients with chronic kidney disease
timeFrame: 6 months
measure: Evaluate mortality during hospital stay
timeFrame: 1 months
measure: Evaluate mortality at medium-term
timeFrame: 6 months
measure: Identify specific therapeutic interventions put into place during the 6 month consultation
timeFrame: 6 months
Other outcomes:
Locations:
city: Nîmes
country: France
facility: CHU Nimes
Study officials:
References: