Active clinical trials for "Acute Kidney Injury"

Fluid overload is associated with adverse outcomes in patients with severe acute kidney injury. It remains unclear if fluid overload is merely a marker of disease severity or if organ congestion is a mediator of complications. Point-of-care ultrasound could be a modality used to assess organ congestion and its clinical implications. The objective of this study is to determine whether ultrasound markers of organ congestion are associated with major adverse kidney events in critically ill patients with severe acute kidney injury.

This observational study evaluates the potential benefits, costs and clinical outcomes of albumin over saline and other non-saline fluids in patients receiving large volume resuscitation.

Sensitive renal markers have been studied abundantly in connection with open heart, liver and transplantation surgery; however in major orthopaedic surgery their use is anecdotal. The aim of the present study is to evaluate use of sensitive renal markers, NGAL (Neutrophil gelatinase associated lipocalin ), KIM-1 (Kidney injury molecule- 1), LFABP (liver-type fatty acid-binding protein), and IL-18 (interleukin -18), in patients coming for elective TKA (total knee arthroplasty) as a pilot study before large study concerning acute kidney injury in orthopaedic surgery.

Title: "Role of biomarkers in predicting contrast-induced acute kidney injury in critically ill patients: a prospective observational study" Objective: To analyse the role of plasma and urinary biomarkers (Neutrophil Gelatinase-Associated Lipocalin (NGAL), Cystatin C and Kidney Injury Molecule-1) in predicting contrast-induced acute kidney injury (CI-AKI) in critically ill patients. Summary of the project: Acute deterioration of renal function after intravenous administration of radiocontrast media, i.e. increase in serum creatinine concentration of more than 0.5 mg/dl or 25% above baseline within 48 hours, is referred to as contrast-induced kidney injury (CI-AKI). The increasing number of diagnostic procedures requiring radiographic contrast has parallel increase in the incidence of CI-AKI. CI-AKI is described as the third most common cause of new AKI in hospitalized patients. Occurrence of CI-AKI is reported up to 55% in high risk patients like presence pre-existing chronic renal dysfunction, diabetes, hypertension, chronic heart failure, advanced age, volume depletion, uses of concurrent nephrotoxic medication. These risk factors for CI-AKI are common in critically ill patients. Recently, different urinary and serum proteins have been intensively investigated as possible biomarkers for the early diagnosis of AKI, which includes Neutrophil Gelatinase-Associated Lipocalin (NGAL), Cystatin C and Kidney Injury Molecule-1 (KIM 1). At present, there is scarcity of prospective study on CI-AKI and role of biomarkers in critically ill medical or medical-surgical mixed ICU patients. The investigators plan to enroll about 100 ICU patients during 2 years, requiring computed tomography (CT) scans with parenteral administration of iodinated radiographic contrast for any diagnostic purposes as decided by the clinicians during the treatment of the patients. In this prospective observation study, the investigators want to analyse the role of plasma and urinary biomarkers in predicting CI-AKI in critically ill patients. Key Words: acute kidney injury, radiographic contrast, critically ill, biomarker

Intraoperative intravenous fluid management practice varies greatly between anesthesiologists. Postoperative fluid based weight gain is associated with major morbidity. Postoperative respiratory complications are associated with increased morbidity, mortality and hospital costs. The literature shows conflicting data regarding intraoperative fluid resuscitation volume. No large-scale studies have focused on intraoperative fluid management and postoperative respiratory dysfunction. Hypotheses: Primary - Liberal intraoperative fluid resuscitation is associated with an increased risk of 30 day mortality Secondary - Liberal intraoperative fluid resuscitation is associated with increased likelihood of postoperative respiratory failure, pulmonary edema, reintubation, atelectasis, acute kidney injury and peri-extubation oxygen desaturation.

To examine two main predictor variables independently and then jointly in stratified and multivariate analyses for the outcomes of CSA-AKI, MARCE, need for RRT, and inpatient mortality, and the composite, as well as the outcomes of 30 day rehospitalization or death, and finally for the days out of hospital and alive adjusted to person-year of time Days from coronary angiogram performed with IOCM to cardiac surgery (1, 2, 3, etc) Thakar Acute Renal Failure (ARF) score (1 to 17) To examine the interrelationships between time in days between angiogram and surgery and the ARF Score with the Society of Thoracic Surgery (STS) Risk score for mortality

Acute kidney injury (AKI) is a common complication in critical care patients. Currently no parameters are available for early prognosis of AKI. Macrophage migration inhibitory factor (MIF) has been associated with AKI in clinical studies. The aim of this study is to evaluate the time course of MIF concentrations in patients with AKI.

Contrast-induced acute kidney injury (CIAKI) is a major complication with adverse outcomes after contrast media injection. Although the risk of developing CIAKI is low in patients with normal renal function, it is dramatically higher in patients with conditions such as diabetes mellitus (DM) or chronic kidney disease (CKD). More recently, our data showed that contrast agents can induce endothelial dysfunction partially via free radicals in diabetes. Therefore, strategies to prevent CIAKI and endothelial dysfunction in DM patients with CKD are urgently needed. Alpha-lipoic acid and its reduced form, dihydrolipoate, are potent antioxidants. We hypothesized that alpha lipoic acid can prevent the contrast-induced acute kidney injury and endothelial dysfunction in type 2 diabetes.

Pediatric acute kidney injury (AKI) is associated with increased morbidity and mortality in critically ill patients. Currently, understanding of the epidemiology and diagnosis of AKI in children is limited by single center retrospective data and inconsistent diagnostic and stratification criteria. The hypotheses of the AWARE study is that 1) renal angina, a composite of early injury signs and risk of disease, will predict severe subsequent AKI in critically ill children and 2) the incorporation of urinary biomarkers into the renal angina scoring system will improve the prediction of the severe injury. The AWARE study is conducted to describe AKI epidemiology in a heterogeneous multinational cohort of critically ill children, characterize AKI risk factors and associated morbidity, and validate the KDIGO AKI criteria as a predictor of pediatric AKI outcomes. The multi-center, multi-national registry will create the largest ever repository of information available on AKI in children.

The objective of this sample collection study is to collect blood and urine samples. This study is observational and will have no impact on the medical management of the subject.