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- Klinische proef 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
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
- Diagnostische toets: Iohexol renal clearance measurement
- Diagnostische toets: Cystatin C
- Diagnostische toets: Creatinine
- Diagnostische toets: Metagenome analysis
- Diagnostische toets: Bioimpedance analysis
- Ander: Patient reported outcome measures
- Ander: Measurement of physical performance
- Ander: Semi structured interview
- Ander: Participatory workshop
Studietype
Inschrijving (Geschat)
Contacten en locaties
Studiecontact
- Naam: Kerry Horne Dr, BMBCh
- Telefoonnummer: +44 01332 788262
- E-mail: kerry.horne@nottingham.ac.uk
Studie Locaties
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Derbyshire
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Derby, Derbyshire, Verenigd Koninkrijk, DE22 3DT
- Werving
- University Hospitals of Derby and Burton NHS Foundation Trust
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Contact:
- Kerry Horne Dr
- Telefoonnummer: 01332788262
- E-mail: kerry.horne@nottingham.ac.uk
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-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Bemonsteringsmethode
Studie Bevolking
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
Beschrijving
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)
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
|---|---|
|
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
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|
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.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
The proportion of eligible patients who agree to participate
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 3 months
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3 months
|
|
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Gut microbiome composition
Tijdsspanne: 3 months
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Assessed through metagenomics
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3 months
|
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Codes and themes related to patient experience after AKI, identified from systematic qualitative analysis of interview transcripts
Tijdsspanne: 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
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
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The mean difference between eGFR-cystatin and eGFR-creatinine
Tijdsspanne: 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)
Tijdsspanne: 3 months
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3 months
|
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Correlation between eGFR creatinine and eGFR cystatin
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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)
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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 uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Safety Outcomes
Tijdsspanne: 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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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Nicholas Selby, University of Nottingham
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Urogenitale ziekten
- Pathologische processen
- Mannelijke urogenitale ziekten
- Nier Ziekten
- Urologische ziekten
- Vrouwelijke urogenitale ziekten
- Vrouwelijke urogenitale ziekten en zwangerschapscomplicaties
- Chronische ziekte
- Ziekte attributen
- Nierinsufficiëntie
- Pathologische aandoeningen, tekenen en symptomen
- Acuut nierletsel
- Nierinsufficiëntie, chronisch
- Health Services Administration
- Kwaliteit, toegang en evaluatie van de gezondheidszorg
- Onderzoekstechnieken
- Epidemiologische methoden
- Gegevensverzameling
- Evaluatiemechanismen voor gezondheidszorg
- Kwaliteit van de gezondheidszorg
- Volksgezondheid
- Milieu en volksgezondheid
- Gezondheidszorg economie en organisaties
- Uitkomstbeoordeling, gezondheidszorg
- Uitkomst en procesbeoordeling, gezondheidszorg
- Enquêtes en vragenlijsten
- Gezondheidsplanning
- Enquêtes in de gezondheidszorg
- Onderzoek naar gezondheidsdiensten
- Patiëntuitkomstbeoordeling
- Patiënt gerapporteerde uitkomstmaten
Andere studie-ID-nummers
- 25019
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Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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