Serial CrCl in AKI
Research type
Research Study
Full title
Serial measurements of 1 hour creatinine clearances in critically ill patients at risk of acute kidney injury
IRAS ID
187179
Contact name
Barbara J Philips
Contact email
Sponsor organisation
St George's University of London
Duration of Study in the UK
0 years, 3 months, 30 days
Research summary
Acute kidney injury (AKI) is the failure of the kidneys to function properly over a short period of time. AKI may be caused by illness affecting the kidneys themselves but is more often the consequence of other severe or critical illnesses such as sepsis or shock . It is a common complication of illness amongst patients admitted to intensive care and when it occurs it is associated with a significantly increased risk of death.
Renal function may be described in terms of the glomerular filtration rate (GFR, rate at which the kidney filters toxins from the body) but this is been very difficult to measure clinically in sick patients. This absence of accurate methods of measuring changing GFR in AKI has posed a significant barrier to research and identifying when problems arise in AKI remains challenging. Current definitions of AKI stages 1-3 are based upon increased serum creatinine concentration (SCr) or reduced urine output (UO) and categorised using the kidney disease improving global outcomes (KDIGO) consensus criteria. These provide a pragmatic solution to defining AKI for research but there are significant limitations to these parameters in critically ill patients. Changes in SCr sufficient to define AKI may be delayed in patients with chronic kidney disease (CKD) who have a high baseline SCr and in sepsis creatinine formation may be reduced. In both cases both the occurrence and the severity of AKI may be underestimated. We have recently shown in a clinical trial that a simple measure of 1 hour creatinine clearances (1-CCl) compares well with the renal clearance of Iohexol. The former requires only urine and blood for creatinine analysis and is simple to do and gives us the opportunity to collect some preliminary data to look at the rapidity of changes in GFR over time.REC name
London - Queen Square Research Ethics Committee
REC reference
15/LO/1720
Date of REC Opinion
20 Oct 2015
REC opinion
Favourable Opinion