Acute Kidney Injury

Intensive Care Nephrology Pathway (this will be divided into the 3 levels) 

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STARRT-AKI

Aim

To determine whether, in critically ill patients with severe acute kidney injury (AKI), a strategy of accelerated (early) initiation of renal replacement therapy (RRT), compared to a standard (delayed) strategy for initiation of RRT contributes to improved 90-day survival and recovery of kidney function.  

Design

Multi-national, multicentre, open-label, randomised, controlled trial. The trial is currently enrolling participants in 6 countries at 44 sites. The trial anticipates a total of 14 countries and approximately 100 sites.

AKI-EPI

Epidemiologic Prospective Investigation

The aim of the study is to evaluate the epidemiology and early management of acute kidney injury, according to the RIFLE classification in ICU patients.

Further information can be found at www.akinet.org.

Eric Hoste Interview

In this icTV interview, we sit down with Eric Hoste, to discuss the AKI-EPI study – one of the most accessed articles in Intensive Care Medicine in 2015/2016.

PrevAKI

PrevAKI is a multicentre, prospective, randomised controlled parallel group trial, which will assess biomarker-guided implementation of the KDIGO guidelines in the prevention of AKI. The pubication of the primary paper is expected  in the course of 2021.

The hypothesis: Implementation of the KDIGO guidelines in cardiac surgery patients at high risk for AKI identified by biomarker reduces the occurrence of AKI by approximately 15% compared to standard care.

URV-RRT

There will soon be a new endorsed international survey on Renal replacement therapy modalities in intensive care units in 2021. It is planned for June 2021.

The main objective of this survey is to describe the factors influencing the choice of a particular RRT modality in ICU’s in 2021.

FluidRRT

TA Survey of Fluid Removal Practices During Renal Replacement Therapy in Critically Ill Patients (FluidRRT).
The purpose of this research survey is to study the attitudes of care providers towards fluid removal practices during renal replacement therapy.

Steering Committee: Dr. Raghavan Murugan, Professor Eric Hoste, University of Ghent, Ghent-Belgium, Chair of AKI section and Dr Marlies Ostermann Guy’s & St Thomas’ Hospital, London-UK

Publication: Murugan R et al. (2019) Net Ultrafiltration Prescription and Practice Among Critically Ill Patients Receiving Renal Replacement Therapy: A Multinational Survey of Critical Care Practitioners . Crit Care Med. 2019 Nov 13.

Ostermann M. et al. (2019). Report of the first AKI Round Table meeting: an initiative of the ESICM AKI
Section

Meersch M, Schmidt C, Hoffmeier A, et al. Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomised controlled trial.

Peter Pickkers et al. The intensive care medicine agenda on acute kidney injury

Thiago Gomes Romano et al. Effect of continuous dialysis on blood pH in acidemic hypercapnic animals with severe acute kidney injury: a randomised experimental study comparing high vs. low bicarbonate affluent

Hans Flaatten and Michael Darmon. A nephrologist should be consulted in all cases of acute kidney injury in the ICU: yes

John A. Kellum and Eric A. J. Hoste. A nephrologist should be consulted in all cases of acute kidney injury in the ICU: No

Timing of Renal Replacement Therapy in Patients with Acute Kidney Injury and Sepsis

Effects of timing of renal replacement therapy in ICU patients with AKI

Can KDIGO panel guidelines prevent cardiac surgery-associated AKI?