Renal Replacement in Acute Kidney Injury During Moderate Metabolic Disarray

中度代谢紊乱期间急性肾损伤的肾脏替代治疗

基本信息

  • 批准号:
    8320534
  • 负责人:
  • 金额:
    $ 7.23万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2011
  • 资助国家:
    美国
  • 起止时间:
    2011-08-05 至 2013-07-14
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Acute kidney injury (AKI) is a common complication of critical illness, with even minor degrees of AKI conferring an independent risk of death (1, 2). No therapy currently exists that has been definitively demonstrated to improve outcomes in AKI, although renal replacement therapy (RRT) is frequently necessary as a life-sustaining measure once oliguria, severe azotemia, or significant electrolyte abnormalities develop. Defining the indications for and timing of RRT in the setting of AKI is a priority research topic identified by the Acute Kidney Injury Network. Prior studies examining timing of RRT in acute kidney injury typically have been limited to patients with AKI who received RRT, rendering them unable to evaluate the indications for this therapy, and the impact of therapy versus no therapy (3, 4). Reframing the questions regarding RRT in the setting of AKI, we have designed a study to examine the impact on mortality of initiating dialysis therapy during a period of moderate metabolic disarray, defined as the period of time after acute kidney injury, when laboratory abnormalities are detectable, but before absolute indications for dialysis have arisen. We take advantage of the variations in clinical practice during early AKI prior to when RRT is required as a life-sustaining measure to design an observational study that will permit us to accomplish the following specific aims: Aim 1: Develop a metric defining moderate metabolic disarray and assess the association of duration and severity of moderate metabolic disarray prior to initiation of RRT with the rate of mortality. We will create a score based on a multiple regression model of likelihood to receive dialysis based on a variety of factors, and use that likelihood to define degree of disarray. We will then assess the impact of duration and severity of moderate disarray with these methods (censored at initiation of dialysis or development of severe disarray) on predicting in-hospital mortality. Aim 2: Assess the impact of renal replacement therapy (RRT) initiated during moderate metabolic disarray on in-hospital mortality in a cohort of critically ill patients with AKI The proposed research project will be in the context of the applicant working towards a Masters of Science in Clinical Epidemiology, whereby didactic learning in the classroom, focusing on fundamentals of epidemiology, study design, and statistical and analytic methods of research will enhance and guide the research process of the applicant. The long-term objectives of the applicant for this project are to collect and analyze the data, prepare manuscripts for publication, and build upon the data as part of a future application for a K award.
描述(由申请人提供):急性肾损伤(阿基)是危重病的常见并发症,即使是轻微程度的阿基也会导致独立的死亡风险(1,2)。目前尚无明确证明可改善阿基结局的治疗,但一旦出现少尿、重度氮质血症或显著电解质异常,肾脏替代治疗(RRT)通常是必要的生命维持措施。确定阿基背景下RRT的适应症和时间是急性肾损伤网络确定的优先研究主题。既往研究检查了急性肾损伤中RRT的时机,通常仅限于接受RRT的阿基患者,使其无法评价该治疗的适应症以及治疗与未治疗的影响(3,4)。我们重新定义了阿基背景下RRT的相关问题,设计了一项研究,以检查在中度代谢紊乱期间开始透析治疗对死亡率的影响,中度代谢紊乱定义为急性肾损伤后可检测到实验室异常但出现透析绝对指征之前的一段时间。我们利用需要RRT作为生命维持措施之前早期阿基期间临床实践的变化,设计了一项观察性研究,使我们能够实现以下特定目标:目标1:制定定义中度代谢紊乱的指标,并评估开始RRT之前中度代谢紊乱的持续时间和严重程度与死亡率的相关性。我们将根据多种因素的可能性的多元回归模型创建一个分数,并使用该可能性来定义混乱程度。然后,我们将用这些方法(在开始透析或发展为严重功能障碍时删失)评估中度功能障碍的持续时间和严重程度对预测住院死亡率的影响。目标二:评估在中度代谢紊乱期间开始的肾脏替代治疗(RRT)对阿基危重患者队列的院内死亡率的影响拟议的研究项目将在申请人攻读临床流行病学硕士学位的背景下进行,从而在课堂上进行教学式学习,重点是流行病学的基础知识,研究设计,研究的统计和分析方法将加强和指导申请人的研究过程。该项目申请人的长期目标是收集和分析数据,准备出版手稿,并将数据作为未来K奖申请的一部分。

项目成果

期刊论文数量(7)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Vancomycin levels are frequently subtherapeutic during continuous venovenous hemodialysis (CVVHD).
在连续的静脉血液透析(CVVHD)期间,万古霉素水平经常是亚治疗。
  • DOI:
    10.5414/cn106993
  • 发表时间:
    2012-04
  • 期刊:
  • 影响因子:
    1.1
  • 作者:
    Wilson FP;Berns JS
  • 通讯作者:
    Berns JS
Sundays and mortality in patients with AKI.
AKI 患者的周日和死亡率。
Tumor lysis syndrome: new challenges and recent advances.
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FRANCIS PERRY WILSON其他文献

FRANCIS PERRY WILSON的其他文献

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{{ truncateString('FRANCIS PERRY WILSON', 18)}}的其他基金

Personalized Recommendations for Acute Kidney Injury (AKI) Care Using a Kidney Action Team: A Randomized Trial
肾脏行动小组针对急性肾损伤 (AKI) 护理的个性化建议:随机试验
  • 批准号:
    10211505
  • 财政年份:
    2021
  • 资助金额:
    $ 7.23万
  • 项目类别:
Personalized Recommendations for Acute Kidney Injury (AKI) Care Using a Kidney Action Team: A Randomized Trial
肾脏行动小组针对急性肾损伤 (AKI) 护理的个性化建议:随机试验
  • 批准号:
    10608966
  • 财政年份:
    2021
  • 资助金额:
    $ 7.23万
  • 项目类别:
Personalized Recommendations for Acute Kidney Injury (AKI) Care Using a Kidney Action Team: A Randomized Trial
肾脏行动小组针对急性肾损伤 (AKI) 护理的个性化建议:随机试验
  • 批准号:
    10385755
  • 财政年份:
    2021
  • 资助金额:
    $ 7.23万
  • 项目类别:
Optimizing Electronic Alerts for Acute Kidney Injury
优化急性肾损伤的电子警报
  • 批准号:
    10337243
  • 财政年份:
    2018
  • 资助金额:
    $ 7.23万
  • 项目类别:
Mediators & prognostic value of muscle mass & function in chronic kidney disease
调解员
  • 批准号:
    8700394
  • 财政年份:
    2013
  • 资助金额:
    $ 7.23万
  • 项目类别:
Mediators & prognostic value of muscle mass & function in chronic kidney disease
调解员
  • 批准号:
    8973660
  • 财政年份:
    2013
  • 资助金额:
    $ 7.23万
  • 项目类别:
Mediators & prognostic value of muscle mass & function in chronic kidney disease
调解员
  • 批准号:
    8853857
  • 财政年份:
    2013
  • 资助金额:
    $ 7.23万
  • 项目类别:
Mediators & prognostic value of muscle mass & function in chronic kidney disease
调解员
  • 批准号:
    9267351
  • 财政年份:
    2013
  • 资助金额:
    $ 7.23万
  • 项目类别:
Mediators & prognostic value of muscle mass & function in chronic kidney disease
调解员
  • 批准号:
    8581453
  • 财政年份:
    2013
  • 资助金额:
    $ 7.23万
  • 项目类别:
Mortality Effect of Renal Replacement Therapy for Acute Kidney Injury Initiated D
肾脏替代治疗对急性肾损伤的死亡率影响启动 D
  • 批准号:
    8202629
  • 财政年份:
    2011
  • 资助金额:
    $ 7.23万
  • 项目类别:
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