Active clinical trials for "Acute Kidney Injury"

The aim of this work is to assess the clinical significance of serum levels of neutrophil gelatinase-associated lipocalin (NGAL) to predict AKI in patients exposed to PCI.

The aim of the study are: 1) To evaluate the occurrence of acid-base alterations and the incidence of hypophosphatemia during different modalities of Renal Replacement Terapy (RRT) in critically ill patients [CVVH, CVVHDF and SLED (Sustained Low-Efficiency Dialysis)] by using a simplified Regional Citrate Anticoagulation (RCA) protocol combined with the adoption of a phosphate-containing solution as dialysate and/or replacement fluid; 2) To optimize the infusion rates of different solutions adopted, including citrate, in order to obtain an appropriate electrolyte and buffer supply. The final aim of this approach will be to reduce the need for frequent monitoring of acid-base status and electrolytes (with special regard to ionized calcium levels), and to avoid the need for frequent adjustments of RCA-RRT parameters (infusion rate of different solutions, electrolytes supplementation in the course of RRT). This approach could allow to simplify anticoagulation protocols with citrate, in order to minimize potential concerns hampering a wider diffusion of RCA in daily practice.

Approximately 25-35% of all children admitted to the paediatric intensive care unit (PICU) or neonatal intensive care unit (NICU) will develop Acute Kidney Injury (AKI) during the first seven days after admission. AKI is associated with a worse outcome, including an increased risk of mortality compared to patients without AKI. However, this AKI prevalence estimation is based on serum creatinine based glomerular filtration rate (eGFR), which is known to be inaccurate. The investigators postulate that measured GFR (mGFR) based on iohexol clearance in critically ill children will detect a higher prevalence of children with AKI than currently used methods based on endogenous markers. This study will additionally provide mechanistic knowledge on the relative contribution of GFR and renal transport to renal function in critically ill children.

This prospective cohort study aims to explore the susceptibility to acute kidney injury after heart surgery in SMN1+/- genotype population. This study also aims to analysis the effect of SMN1+/- genotype on postoperative AKI and the development of chronic kidney disease, as well as dose-compensating effect of different copy number of SMN2 gene on SMN1 +/- genotype.

Acute kidney injury occurs in up to 30% of patients undergoing cardiac surgery. Cardiac surgery associated-acute kidney injury (CSA-AKI) is characterized by a sudden and sustained decrease in renal function with insufficient elimination waste products. The problem is that postoperative diagnosis of CSA-AKI is delayed because it relies solely upon the slow and unreliable rise in serum creatinine (SCr) levels that may lead to delayed start in treatment and increased risk of adverse outcomes. We hypothesize that Matrix Metalloproteins (MMPs) -2, -9 and Neutrophil gelatinase-associated lipocalin (NGAL) are associated with and earlier detectors of CSA-AKI compared to levels of SCr.

The study aims to determine how historical cases of respiratory abnormalities are documented by clinicians in the electronic health records (EHR) of Memorial Hermann Healthcare System (MHHS) inpatient facilities. The knowledge gained from this study will support the design of modern data-driven surveillance approach to continuously collect, monitor and timely recognize postoperative respiratory abnormalities using electronic healthcare recorded data.

One in five patients admitted to hospital suffer a sudden reduction in kidney function, termed acute kidney injury (AKI). Rather than kidney 'injury' being caused by physical trauma, the term describes reversible damage caused by conditions such as being dehydrated or having an infection. Having AKI puts patients at an increased risk of long-term health problems, especially chronic kidney disease (CKD). CKD can also lead to other important health problems including a higher risk of heart disease and stroke. If we can reduce the progression of AKI to CKD this will benefit patients. Currently, there is a gap in the follow-up of patients after AKI due to a lack of evidence about which patients should be followed up and when. Treatments for AKI during the episode and afterwards to prevent CKD are limited. This is mainly due to a lack of understanding about how and when the kidney recovers after AKI. New tools are needed in order to better identify patients at risk of CKD after AKI. This study aims to address these gaps in our knowledge by studying a group of AKI patients in detail. Ultimately, the aim of this study is to produce results that will allow better planning of follow-up for patients as well the planning of future research to develop new treatments to reduce the risk of CKD in people recovering from AKI.

This is a prospective observational parallel group cohort study that will aim to recruit 220 participants who were admitted to the hospital with COVID-19 between 1st March 2020 and 30th June 2020 (Group A - 110 participants who had COVID-19 with AKI; Group B - 110 participants who had COVID-19 without AKI). Data from groups A and B will be compared with AKI and non-AKI groups from an existing study database (ARID study, n=1125) who were recruited before the outbreak of the COVID-19 pandemic (recruitment 2013-2016) and who have all completed at least three years of follow up. Participants who have recovered from COVID-19 will be matched for analysis to participants from the ARID study for AKI status, baseline estimated glomerular filtration rate (eGFR) stage, age (± 5 years) and presence of diabetes. Potential participants will receive a letter of invitation along with a comprehensive participant information sheet (PIS).

B-type natriuretic peptide (BNP) is rapidly released by the ventricles of the heart in response to myocardial stretch. This cardiac neurohormone is mostly elevated in patients with fluid overload or myocardium dysfunction. BNP is a very useful and important marker. It can predict mortality and cardiac events in patients in the ICU setting. In stable hemodialysis patients with normal LV function on echocardiography, high BNP levels are likely the result of blood volume expansion and require reduction in postdialysis dry weight. In the past, there were many methods to evaluate fluid status. Some are not reliable such as central venous pressure or physical examination. Some are invasive and expensive such as Swan Ganz、PiCCO catheter or bioimpedance device. Nevertheless, About the relationship between BNP and fluid status, a study found a significant relation between bioimpedance-derived body composition (BC) (fluid distribution) parameters and BNP concentrations. This relationship was independent of the cardiac history of the patient and suggests that the natriuretic peptide levels are to some degree modifiable by changing a patient's fluid distribution. In this study, the investigators want to observe that if the level of BNP can predict the occurrence of acute kidney injury and the need of renal replacement therapy. Besides, the investigators also want to see if BNP can be a useful and convenient marker to guide adjustment of optimal fluid status and then to improve outcome.

The purpose of this study is to determine soluble HJV could be an early diagnosis urinary biomarker of ischemia/reperfusion injury in post CPB-patients.