Identifying Risk Factors for Developing AKI in Sepsis
A Retrospective Study to Evaluate the Prevalence of Acute Kidney Injury in Patients With DKA and Sepsis
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
It is a descriptive study to report the prevalence ofAcute Kidney Injury ( AKI) in the two cohorts of sepsis and Diabetic Ketoacidosis ( DKA). In addition we aim to evaluate the relation with hyperchloremia. In both groups, attempts will be made to evaluate the association of risk factors such as severity of dehydration/shock and hyperchloremia with AKI in the two groups.
Data will be analysed using SPSS software. Categorical variables will be analysed using Chi-square test and if appropriate, multiple logistic regression analysis. Continuous variable will be analysed with Student's T test and if possible, by linear regression modelling. The differences between the two groups may analysed using Analysis of Variance (ANOVA).
The study will collect anonymous data from 2015 to 2020 from the Paediatric Intensive Care Audit Network (PICANet) database for a tertiary PICU servicing the pediatric population of Wales.This data is submitted prospectively for audit of clinical outcomes of children admitted for paediatric intensive care in the United Kingdom. The study was reviewed by the Institutional Research and Development department and was given exemption for ethics committee review as it does not involve direct patient contact and the data is anonymous. Approval was obtained from the relevant database manager, institutional information governance department as well as the Health Care Research Wales.
Type d'étude
Inscription (Réel)
Contacts et emplacements
Lieux d'étude
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South Glamorgan
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Cardiff, South Glamorgan, Royaume-Uni, CF14 4XW
- Noah's Ark Children's Hospital
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
Children admitted to PICU with sepsis as per the sepsis consensus conference (2005) definition.
Children with DKA admitted to PICU and wards. Diabetic Ketoacidosis defined based on the British Paediatric Society of Endocrinology and Diabetes.
La description
Inclusion Criteria
- Children under 16 years and admitted to PCCU or wards in the past 5 years
- Diagnosis of DKA or Sepsis/severe bacterial infection/septic shock
DKA - defined as per the British Society for Paediatric Endocrinology and Diabetes (BSPED) guidance. Sepsis is defined based on the International Pediatric Sepsis Consensus Conference guidance (2005)
8.3. Exclusion Criteria
- Any patients identified as above but not able to obtain case notes for any reason.
- Patients with pre-existing kidney conditions
- Patients with inborn errors of metabolism
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Modèles d'observation: Cohorte
- Perspectives temporelles: Autre
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
|---|---|
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Sepsis
Patients admitted to PICU who are selected from registry based on primary diagnoses with codes for the following search codes were selected: Sepsis is defined as per the International Consensus Conference pediatric sepsis definition (2005) [citation 1]. In silico analysis will be carried out in the sepsis cohort comparing admissions with Acute Kidney Injury (AKI) and those without AKI to identify factors associated with AKI. In those selected admissions to PICU, information on Renal Function, Chloride levels, clinical outcome and medication use as well as fluid resuscitation will be collected from hospital online resources such as discharge summaries, results portal and the PICANet database. In addition the Paediatric Index of Mortality 3 severity of illness scores will be reported for all admissions. Sepsis will be defined based on the International Pediatric Consensus Conference definition of sepsis (2005) |
aucune intervention
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Diabetic Ketoacidosis (DKA)
This group is defined based on the British Society of Paediatric Endocrinology and Diabetes.case definition for Diabetic Ketoacidosis [citation 2]. The data collected will be similar to the sepsis cohort. In silico analysis will be carried comparing those with AKI and without AKI in the DKA cohort. |
aucune intervention
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Prevalence of Acute Kidney Injury in the sepsis and DKA cohorts
Délai: during admission to PICU
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Acute Kidney Injury will be defined based on the Kidney Disease Improving Global Outcomes (KDIGO) 2012 [citation 3] guidelines.
Serum Creatinine and Urine output will be used for defining Acute Kidney Injury.
Serum creatinine is measured in microMol/litre and urine output in millilitres (ml)
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during admission to PICU
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Risk factors associated with AKI
Délai: During admission to PICU
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Various risk factors will be evaluated such as cardiac arrest prior to admission or during admission, mechanical ventilation, hypotension or shock requiring vaso-active medications as well as use of medications which may be nephrotoxic.
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During admission to PICU
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Compare chloride levels in the AKI and non AKI groups
Délai: during admission in PICU
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The units used for Chloride levels is mMol/Litre
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during admission in PICU
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Collaborateurs et enquêteurs
Parrainer
Publications et liens utiles
Publications générales
- 2. Link to the guidelines documents accessed on 29/03/3-21:https://www.bsped.org.uk/media/1798/bsped-dka-guideline-2020.pdf
- Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline for acute kidney injury.Kidney Int Suppl. 2012;2:1-141. doi: 10.1038/kisup.2012.3
- Goldstein B, Giroir B, Randolph A; International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005 Jan;6(1):2-8. doi: 10.1097/01.PCC.0000149131.72248.E6.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Processus pathologiques
- Troubles du métabolisme du glucose
- Maladies métaboliques
- Infections
- Maladies rénales
- Maladies urologiques
- Syndrome de réponse inflammatoire systémique
- Inflammation
- Maladies du système endocrinien
- Complications du diabète
- Diabète sucré
- Insuffisance rénale
- Déséquilibre acido-basique
- Acidose
- État septique
- Toxémie
- Lésion rénale aiguë
- Cétose
- Acidocétose diabétique
Autres numéros d'identification d'étude
- 20/DEC/8064
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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