STIRS

  • Research type

    Research Study

  • Full title

    Strategy for timely intervention of renal support in the ICU

  • IRAS ID

    237589

  • Contact name

    Marlies Ostermann

  • Contact email

    Marlies.Ostermann@gstt.nhs.uk

  • Sponsor organisation

    University of California San Diego

  • Clinicaltrials.gov Identifier

    NCT03244514

  • Duration of Study in the UK

    3 years, 0 months, 1 days

  • Research summary

    Critically ill patients who develop acute kidney injury (AKI) have high hospital mortality rates in excess of 50%, despite remarkable improvements in the overall intensive care treatment and the availability of new renal replacement therapy (RRT) methods. RRT is an essential component of modern critical care but the optimal time for starting RRT remains unknown. Furthermore, we do not have a reproducible approach for evaluating patients to decide who needs RRT in the intensive care unit (ICU) setting. It is our hypothesis that there is a need for a dynamic risk-stratification tool to identify patients who will or won't need RRT for management of their AKI.

    In collaboration with a team in San Diego (US), we previously developed a clinical index based on routinely available clinical and laboratory parameters. The index represents the relationship between metabolic and fluid demands placed on the kidneys versus the capacity of the kidneys to handle the demand (i.e. Demand / Capacity index)

    In this feasibility project, we plan to validate this Demand / Capacity (D/C) index. We propose to demonstrate that sequential assessment of the D/C clinical index in high-risk patients can assist clinicians determining the optimal time for starting, withholding and stopping RRT.

    For this purpose, we plan to analyse sequential routinely available data of 100 high-risk patients and determine their daily D/C clinical index. After the patient has been discharged from the ICU, we present the D/C index together with the clinical data to the treating clinician and explore whether knowledge of the D/C index would have changed their decision to start, withhold or stop RRT.

  • REC name

    London - Harrow Research Ethics Committee

  • REC reference

    18/LO/0718

  • Date of REC Opinion

    12 Jul 2018

  • REC opinion

    Further Information Favourable Opinion