An Early Real-Time Electronic Health Record Risk Algorithm for the Prevention and Treatment of Acute Kidney Injury (ESTOP-AKI)
An Early Real-Time Electronic Health Record Risk Algorithm for the Prevention and Treatment of Acute Kidney Injury: A Randomized Trial of an Early Standardized, Personalized Nephrology Intervention
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Sharon Trevino, RN
- Phone Number: 773-702-6201
- Email: strevino@medicine.bsd.uchicago.edu
Study Locations
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Illinois
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Chicago, Illinois, United States, 60637
- University Of Chicago Medical Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age >18 years old
- Initial ESTOP AKI score ≥0.01 within the last 8 hours.
Exclusion Criteria:
- Voluntary refusal or missing written consent of the patient / legal representative.
- Patients with a known history of end-stage renal disease on dialysis (including renal transplantation).
- Patients without a measured serum creatinine value during their inpatient stay.
- Patients with a creatinine >4.0 mg/dl at the time of admission or available in the electronic health record (EHR) from the last 6 months.
- Patients with prior episode of Kidney Disease Improving Global Outcomes (KDIGO) defined AKI during this same hospitalization- regardless of ESTOP AKI score.
- Patients with prior renal consultation during their admission.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Early Nephrology Consult (ENC)
The ENC will be a structured consultative note that will provide detailed recommendations around issues such as Differential Diagnosis, Drug Dosing and Volume Status.
The research ENC will have a daily follow-up with documented recommendations.
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The electronic risk prediction algorithm (ESTOP-AKI) will interface with electronic medical data to determine the likelihood for the patient to develop AKI.
Early Nephrology Consult (ENC) will be implemented.
A nephrologist will assess the subject and consult with their care team to advise a treatment plan during the hospitalization.
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Active Comparator: Standard of Care (SOC)
Subjects will receive nephrology consultation at the typical timepoint after symptoms of AKI appear.
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Subjects will receive nephrology consultation at the typical timepoint after symptoms of AKI appear.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Peak change in milligrams per deciliter (mg/dL) in serum creatinine (SCr) level over a 7-day interval
Time Frame: 7-day interval
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The primary endpoint of interest, change in serum creatinine (SCr), is the peak change from study entry in SCr level over a 7-day interval.
The change in SCr is defined as the maximal change in creatinine over this interval, and aim to detect a clinical difference in change in SCr between the SOC and ENC treatment groups.
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7-day interval
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Differences by treatment group in the proportion by percent and time in days to specified medical events.
Time Frame: 3 months
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The differences will be measured by treatment group in the proportion and time to event of patients who a) develop > Stage 2 AKI, b) require renal replacement therapy (RRT), c) undergo intensive care unit (ICU) transfer, and/or d) require non-research nephrology consult.
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3 months
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Comparison of treatment groups in the proportion by percent and time in days of length of stay (LOS) in the hospital.
Time Frame: 3 months
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The differences will be measured by treatment group in the proportion by percent and time in days of LOS in the hospital.
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3 months
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Jay Koyner, MD, University of Chicago Medicine
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Male Urogenital Diseases
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Renal Insufficiency
- Acute Kidney Injury
- Health Services Administration
- Health Care Quality, Access, and Evaluation
- Quality of Health Care
- Quality Indicators, Health Care
- Standard of Care
Other Study ID Numbers
Other Study ID Numbers
- IRB17-1081
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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