CODE-AKI: COnservative Dialysis to Enhance AKI Recovery
CODE-AKI:保守透析促进 AKI 恢复
基本信息
- 批准号:10912233
- 负责人:
- 金额:$ 12.81万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-09-11 至 2025-06-30
- 项目状态:未结题
- 来源:
- 关键词:AcuteAcute Renal Failure with Renal Papillary NecrosisArtificial KidneyBiologicalBloodClinicalClinical TrialsComplicationCost SavingsCreatinineDetectionDiagnosisDialysis procedureExcisionHemodialysisHospitalizationHospitalsHypotensionIL18 geneInjuryInjury to KidneyInterleukin-6Interleukin-8InterventionIntervention StudiesKidneyLCN2 geneLiquid substanceMasksMembraneMetabolicOutcomeOutputParticipantPatient-Focused OutcomesPatientsPlasmaPopulationPositioning AttributePublic HealthRandomizedRandomized, Controlled TrialsRecoveryRenal Replacement TherapyRenal functionScheduleSerumSpecific qualifier valueSupportive careTNFR-Fc fusion proteinTNFRSF1A geneTestingTimeTubular formationUrineVentilatorVulnerable PopulationsWorkclinical practicehemodynamicshypoperfusionimmune activationimprovedinsightpilot trialprimary outcomerat KIM-1 proteinsafety and feasibilitysafety testingsolutesystemic inflammatory responsetrend
项目摘要
ABSTRACT/PROJECT SUMMARY
Dialysis-requiring acute kidney injury (AKI-D) is a devastating complication among hospitalized patients for
which there are no treatments other than supportive care. Recovery of sufficient renal function to stop dialysis
is an unequivocally important clinical and patient-oriented outcome. Shortening dialysis duration and increasing
the number of AKI-D patients who recover would have a major clinical, public health and cost-saving impact.
However, there is currently no evidence to guide the delivery of dialysis to facilitate recovery. We hypothesize
that in patients who have AKI-D and who are hemodynamically stable, a conservative dialysis strategy--in
which hemodialysis is not continued unless specific metabolic or clinical indications for RRT are present--will
improve the likelihood of renal recovery compared with the current standard clinical practice of thrice-weekly
intermittent dialysis. We have conducted a pilot clinical trial to demonstrate the feasibility of this approach. We
propose here a 2-center randomized controlled trial to test our conservative dialysis strategy in a larger AKI-D
population (N = 220). To shed insight into potential pathophysiological mechanisms, we will examine the
impact of the conservative dialysis strategy on not only clinical outcomes but also markers of renal tubular
injury and systemic inflammation. Our specific aims are:
Aim 1: In hospitalized patients with AKI-D, to test whether a conservative dialysis strategy (compared with a
standard thrice-weekly acute dialysis strategy):
a. Increases the proportion of patients with renal recovery at hospital discharge--the primary outcome for
this trial (defined as being alive and off dialysis at the time of discharge, with sustained independence
from dialysis for 14 days which may occur in or out of the hospital);
b. Reduces the number of dialysis sessions/week;
c. Increases the number of dialysis-free days to study day 28 (days alive and not dependent on dialysis,
similar to ventilator-free days).
Aim 2: To determine the impact of a conservative dialysis strategy (compared with a standard thrice-weekly
acute dialysis strategy) on renal tubular injury and systemic inflammation.
Renal tubular injury will be reflected by plasma neutrophil gelatinase-associated lipocalin and kidney injury
molecule-1 levels during the first week of the study intervention. Systemic inflammation will be reflected by
plasma interleukin [IL]-6, IL-8, IL-18 and soluble tumor necrosis factor receptor-1 levels. In aggregate, the
studies proposed here are the next step towards changing the paradigm of dialytic management in patients
with prevalent AKI-D and improving clinical outcomes in this vulnerable population.
抽象/项目总结
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Chi-yuan Hsu其他文献
Chi-yuan Hsu的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Chi-yuan Hsu', 18)}}的其他基金
Living Donor Extended Time Outcomes (LETO) Study
活体捐赠者延长时间结果 (LETO) 研究
- 批准号:
10413009 - 财政年份:2019
- 资助金额:
$ 12.81万 - 项目类别:
Living Donor Extended Time Outcomes (LETO) Study
活体捐赠者延长时间结果 (LETO) 研究
- 批准号:
10164513 - 财政年份:2019
- 资助金额:
$ 12.81万 - 项目类别:
Living Donor Extended Time Outcomes (LETO) Study
活体捐赠者延长时间结果 (LETO) 研究
- 批准号:
9906216 - 财政年份:2019
- 资助金额:
$ 12.81万 - 项目类别:
Living Donor Extended Time Outcomes (LETO) Study
活体捐赠者延长时间结果 (LETO) 研究
- 批准号:
10652284 - 财政年份:2019
- 资助金额:
$ 12.81万 - 项目类别:
CODE-AKI: COnservative Dialysis to Enhance AKI Recovery
CODE-AKI:保守透析促进 AKI 恢复
- 批准号:
10203956 - 财政年份:2019
- 资助金额:
$ 12.81万 - 项目类别:
CODE-AKI: COnservative Dialysis to Enhance AKI Recovery
CODE-AKI:保守透析促进 AKI 恢复
- 批准号:
10655505 - 财政年份:2019
- 资助金额:
$ 12.81万 - 项目类别:
CODE-AKI: COnservative Dialysis to Enhance AKI Recovery
CODE-AKI:保守透析促进 AKI 恢复
- 批准号:
10015269 - 财政年份:2019
- 资助金额:
$ 12.81万 - 项目类别:
CODE-AKI: COnservative Dialysis to Enhance AKI Recovery
CODE-AKI:保守透析促进 AKI 恢复
- 批准号:
10424430 - 财政年份:2019
- 资助金额:
$ 12.81万 - 项目类别:
Living Donor Extended Time Outcomes (LETO) Study
活体捐赠者延长时间结果 (LETO) 研究
- 批准号:
10178007 - 财政年份:2019
- 资助金额:
$ 12.81万 - 项目类别:
Acute kidney injury among patients with chronic kidney disease
慢性肾脏病患者的急性肾损伤
- 批准号:
9978765 - 财政年份:2018
- 资助金额:
$ 12.81万 - 项目类别:














{{item.name}}会员




