- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT07569588
Improving Patient Assessment After Acute Kidney Injury (AKI) (IMPACT-AKI)
The goal of this clinical trial is to improve patient care after acute kidney injury (AKI). It has three related parts. The main questions it aims to answer are:
- Is creatinine or cystatin a more reliable assessment of kidney function after AKI?
- What are the experiences of patients after AKI?
- What interventions should be recommended to improve assessment and support of patients after AKI?
Participants will be asked to do one or more of:
- blood tests to measure kidney function in different ways
- have measurement of their body composition
- complete questionnaires about their symptoms
- have an interview with a researcher about their experiences
- discussion to develop an action plan based on findings
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
- Diagnosetest: Iohexol renal clearance measurement
- Diagnosetest: Cystatin C
- Diagnosetest: Creatinine
- Diagnosetest: Metagenome analysis
- Diagnosetest: Bioimpedance analysis
- Sonstiges: Patient reported outcome measures
- Sonstiges: Measurement of physical performance
- Sonstiges: Semi structured interview
- Sonstiges: Participatory workshop
Studientyp
Einschreibung (Geschätzt)
Kontakte und Standorte
Studienkontakt
- Name: Kerry Horne Dr, BMBCh
- Telefonnummer: +44 01332 788262
- E-Mail: kerry.horne@nottingham.ac.uk
Studienorte
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Derbyshire
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Derby, Derbyshire, Vereinigtes Königreich, DE22 3DT
- Rekrutierung
- University Hospitals of Derby and Burton NHS Foundation Trust
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Kontakt:
- Kerry Horne Dr
- Telefonnummer: 01332788262
- E-Mail: kerry.horne@nottingham.ac.uk
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-
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Probenahmeverfahren
Studienpopulation
Observational study workstream: secondary care nephrology clinics Qualitative interview workstream: secondary care nephrology clinics, hospitalised patients with AKI not followed up in nephrology clinic, participants of other aspects of the study.
Participatory workshop workstream: Organisational and professional organisations with interest in acute kidney injury, professional networks, public and patient involvement and engagement groups
Beschreibung
Inclusion Criteria:
Observational study workstream
- Age 18-85 years
- AKI stage 2 or 3 during hospital admission OR AKI stage 1 of at least 7 days duration during hospital admission
- 60-90 days after peak creatinine Qualitative interview workstream
- Age 18-85 years
- AKI during hospital admission
- 60-90 days after peak creatinine Participatory workshop workstream
- Age 18-85 years
- Relevant experience (as assessed by the investigator) which could include personal experience of an episode of hospitalised AKI as a patient of carer, experience of managing AKI or related problems in a professional capacity or knowledge of a particular community.
Exclusion Criteria:
Observational study workstream
- Inability to give informed consent
- No baseline creatinine available in previous 12 months
- Pregnancy or breastfeeding
- Current treatment with dialysis
- Renal transplant
- Pacemaker in situ
- Previous amputation
- Allergy to Omnipaque contrast agent (WP1 only)
- Manifest thyrotoxicosis (WP1 only)
- Ascites or significant (grade 3 to 4) peripheral oedema, defined as ≥6 mm pit, lasting for >1 minute after 5-second compression over tibia or medial malleolus (WP1 only) Qualitative interview workstream
- Inability to give informed consent
- No baseline creatinine available in previous 12 months
- Current treatment with dialysis
- Renal transplant
- Receiving palliative care Participatory workshop workstream
- Inability to give informed consent
- Inability to communicate in English (the qualitative workshops will be held in English)
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
Kohorten und Interventionen
Gruppe / Kohorte |
Intervention / Behandlung |
|---|---|
|
Observational study
Patients 3 months after hospitalised acute kidney injury
|
Gold standard measurement of glomerular filtration rate.
Estimated GFR using serum cystatin C
eGFR from serum creatinine level
Analysis of the metagenome using faecal samples of participants after acute kidney injury
Estimation of body composition
EQ-5D-5L, KSQ, WHO-DAS 2.0, K10
Hand grip, Short physical performance battery
|
|
Qualitative study
Patients 3 months after hospitalised acute kidney injury
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Semi structured interview to explore patient experiences.
Purposive sampling will be used to explore a wide range of perspectives and transcripts will be analysed using thematic analysis to develop codes and themes.
|
|
Participatory workshops
Individuals with personal or professional experience of acute kidney injury
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Group workshop using qualitative methods.
Purposive sampling will be used to explore a wide range of perspectives and transcripts will be analysed using thematic analysis to develop codes and themes.
These will be used to develop consensus recommendations.
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
The proportion of eligible patients who agree to participate
Zeitfenster: 3 months
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3 months
|
|
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The proportion of participants who have all three measurements (eGFR-cystatin, eGFR-creatinine and measured GFR)
Zeitfenster: 3 months
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3 months
|
|
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Standard deviation of the difference between measured GFR and eGFR-creatinine and eGFR-cystatin
Zeitfenster: 3 months
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3 months
|
|
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The proportion of patients with eGFR <60ml/min/1.73m2 from eGFR-cystatin compared with eGFR creatinine
Zeitfenster: 3 months
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3 months
|
|
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Gut microbiome composition
Zeitfenster: 3 months
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Assessed through metagenomics
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3 months
|
|
Codes and themes related to patient experience after AKI, identified from systematic qualitative analysis of interview transcripts
Zeitfenster: 3 - 12 months
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3 - 12 months
|
|
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Production of a document of recommended next steps through MDT development during participatory workshops
Zeitfenster: At completion of third workshop 3 years after enrolment
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At completion of third workshop 3 years after enrolment
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Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
|---|---|
|
The mean difference between eGFR-cystatin and eGFR-creatinine
Zeitfenster: 3 months
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3 months
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The mean difference between iohexol measured GFR and each estimated GFR method (creatinine and cystatin)
Zeitfenster: 3 months
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3 months
|
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Correlation between eGFR creatinine and eGFR cystatin
Zeitfenster: 3 months
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3 months
|
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Correlation between iohexol measured GFR and each estimated GFR method (creatinine and cystatin)
Zeitfenster: 3 months
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3 months
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Bias between iohexol measured GFR and each estimated GFR method (creatinine and cystatin)
Zeitfenster: 3 months
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3 months
|
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Accuracy of eGFR creatinine and eGFR cystatin compared with iohexol measured GFR as assessed by the percentage of estimated values within 30% of measured GFR (P30)
Zeitfenster: 3 months
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3 months
|
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Correlation of muscle mass with the percentage difference between eGFR-cystatin and eGFR-creatinine
Zeitfenster: 3 months
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3 months
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Correlation of physical function with the percentage difference between eGFR-cystatin and eGFR-creatinine
Zeitfenster: 3 months
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3 months
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Correlation of patient reported outcomes with the percentage difference between eGFR-cystatin and eGFR-creatinine
Zeitfenster: 3 months
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3 months
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Barriers to implementation of recommendations as identified through MDT discussion at participatory workshops
Zeitfenster: At completion of third workshop 3 years after enrolment
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At completion of third workshop 3 years after enrolment
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Andere Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Safety Outcomes
Zeitfenster: From enrolment until the end of study visits (from 3 to 12 months)
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From enrolment until the end of study visits (from 3 to 12 months)
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Mitarbeiter und Ermittler
Sponsor
Ermittler
- Hauptermittler: Nicholas Selby, University of Nottingham
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Primärer Abschluss (Geschätzt)
Studienabschluss (Geschätzt)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Urogenitale Erkrankungen
- Pathologische Prozesse
- Männliche Urogenitalerkrankungen
- Nierenerkrankungen
- Urologische Erkrankungen
- Weibliche Urogenitalerkrankungen
- Weibliche Urogenitalerkrankungen und Schwangerschaftskomplikationen
- Chronische Erkrankung
- Krankheitsattribute
- Niereninsuffizienz
- Pathologische Zustände, Anzeichen und Symptome
- Akute Nierenschädigung
- Niereninsuffizienz, chronisch
- Verwaltung des Gesundheitswesens
- Qualität, Zugang und Bewertung im Gesundheitswesen
- Untersuchungstechniken
- Epidemiologische Methoden
- Datenerfassung
- Gesundheitsbewertungsmechanismen
- Qualität der Gesundheitsversorgung
- Öffentliche Gesundheit
- Umwelt und öffentliche Gesundheit
- Gesundheitsökonomie und Organisationen
- Ergebnisbewertung, Gesundheitsversorgung
- Ergebnis- und Prozessbewertung, Gesundheitswesen
- Umfragen und Fragebögen
- Gesundheitsplanung
- Gesundheitsumfragen
- Forschung im Gesundheitswesen
- Bewertung des Patientenergebnisses
- Patienten gemeldete Ergebnismaßnahmen
Andere Studien-ID-Nummern
- 25019
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Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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