Clinical trial NCT05186636: Dialyzing Wisely - Improving the Delivery of Acute Renal Replacement Therapy to Albertans
Official title: Dialyzing Wisely - Improving the Delivery of Acute Renal Replacement Therapy to Albertans
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Acute Renal Injury
Keywords: evidence based care pathway,
critical care medicine
quality improvement
acute renal replacement therapy
Lead sponsor: University of Alberta
Sponsor class: OTHER
Collaborators: name: Alberta Innovates Health Solutions
First posted: 2022-01-11
Enrollment: 4500
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: All patients from 15 adult and 3 pediatric Alberta ICUs who receive acute RRT as part of their usual clinical care during the intervention period

Brief summary: Implementation of an evidence-based and best practices acute RRT pathway aiming to decrease acute RRT program and healthcare systems costs while improving important patient-reported outcomes.

Detailed description: Providing acute dialysis to critically ill patients in ICU settings is resource and cost intensive. The daily costs of acute dialysis can range from $528/day for intermittent hemodialysis to $865/day for continuous renal replacement therapy. Providing acute dialysis in ICU settings requires a specialized team of nurses, educators, physicians and stakeholders to ensure its safe and effective prescription and delivery. Acute dialysis is typically delivered to some of the most acutely ill patients admitted to the ICU to support organ function and sustain life.

At present, there is not a standardized approach to the prescription and delivery of acute dialysis therapy in ICUs across Alberta. The DIALYZING WISELY program will implement a standardized approach to the delivery of best practices for acute dialysis therapy to all patients who receive treatment across ICUs in Alberta.

Eligibility criteria: Inclusion Criteria:

Patient in one of 15 adult and 3 pediatric intensive care units in Alberta Receive acute RRT as part of their usual clinical care during the intervention period

Exclusion Criteria:

* none

Primary outcomes:
measure: Key performance indicators (KPI)
timeFrame: Throughout intervention period up to 3 years
measure: Health system costs
timeFrame: 3 years
Secondary outcomes:
measure: Length of renal replacement therapy
timeFrame: 3 years
measure: ICU and hospital lengths of stay
timeFrame: 3 years
measure: ICU and 90 day mortality
timeFrame: 3 years
measure: Rates of RRT dependence at 90 days
timeFrame: 3 years
Other outcomes:
Locations:
city: Calgary
country: Canada
facility: Peter Lougheed Centre
state: Alberta
city: Calgary
country: Canada
facility: Foothills Medical Centre
state: Alberta
city: Calgary
country: Canada
facility: Rockyview General Hospital
state: Alberta
city: Calgary
country: Canada
facility: Alberta Children's Hospital
state: Alberta
city: CAlgary
country: Canada
facility: South Health Campus
state: Alberta
city: Edmonton
country: Canada
facility: Royal Alexandra Hospital
state: Alberta
city: Edmonton
country: Canada
facility: Misericordia Community Hospital
state: Alberta
city: Edmonton
country: Canada
facility: Manzankowski Alberta Heart Institute
state: Alberta
city: Edmonton
country: Canada
facility: Stollery Children's Hospital
state: Alberta
city: Edmonton
country: Canada
facility: University of Alberta Hospital
state: Alberta
city: Edmonton
country: Canada
facility: Grey Nuns Community Hospital
state: Alberta
city: Grande Prairie
country: Canada
facility: Grande Prairie Regional Hospital
state: Alberta
city: Lethbridge
country: Canada
facility: Chinook Regional Hospital
state: Alberta
city: Red Deer
country: Canada
facility: Red Deer Regional Hospital Centre
state: Alberta
city: St. Albert
country: Canada
facility: Sturgeon Community Hospital
state: Alberta
Study officials:
affiliation: University of Alberta
name: Oleksa Rewa, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Opgenorth D, Bagshaw SM, Lau V, Graham MM, Fraser N, Klarenbach S, Morrin L, Norris C, Pannu N, Sinnadurai S, Valaire S, Wang X, Rewa OG. A study protocol for improving the delivery of acute kidney replacement therapy (KRT) to critically ill patients in Alberta - DIALYZING WISELY. BMC Nephrol. 2022 Nov 16;23(1):369. doi: 10.1186/s12882-022-02990-6.