View clinical trials related to Acute Kidney Injury.
Filter by:The purpose of this study is to determine whether perioperative intravenous administration of pantoprazole will improve kidney function parameters following cardiac surgery with cardiopulmonary bypass compared to famotidine and to determine whether perioperative intravenous administration of pantoprazole will decrease the incidence of postoperative Acte Kidney Injury (AKI) and major adverse kidney events (MAKE).
Background: Childhood cancer survivors (CCS) are at elevated risk of chronic health conditions. Chemotherapies can cause recurrent acute kidney injury which may progress to kidney fibrosis, chronic kidney disease (CKD) or hypertension (HTN). CCS surviving to adulthood are at ≥3 times the risk (vs. non-CCS) for CKD, HTN and lower quality of life. However, the timing of CKD and HTN onset in CCS completing cancer therapy in childhood remains unclear. Guidelines provide recommendations on managing post-cancer therapy effects in CCS, but they lack specificity on kidney testing content, frequency and complications. This discord is largely due to knowledge gaps on which CCS develop CKD or HTN after cancer therapy, when outcomes occur and their severity. Existing work has shown in select patients, CKD and HTN in CCS likely begins in the first 5 years post-cancer therapy and that the burden is significant. With robust data on CKD and HTN, international CCS follow-up guidelines can be optimized to include detailed and actionable recommendations on kidney and blood pressure monitoring and treatment.
A prospective, randomized, placebo-controlled clinical study to investigate the safety and efficacy of Niyad (nafamostat mesylate) for anticoagulation of extracorporeal blood circulating through a dialysis filter in patients undergoing CRRT who cannot tolerate heparin or are at higher risk for bleeding.
Acute kidney injury (AKI) is a common surgical complication characterized by a rapid decline in renal function. Patients with AKI are at an increased risk of developing chronic kidney disease and end-stage renal disease, which has been associated with an increased risk of morbidity, mortality and financial burdens. Identifying high-risk patients for postoperative AKI early can facilitate the development of preventive and therapeutic management strategies, and prediction models can be helpful in this regard. The goal of this retrospective study is to develop prediction models for postoperative AKI in noncardiac surgery using machine learning algorithms, and to simplify the models by including only preoperative variables or only important predictors.
Accurate preoperative AKI risk prediction is of great significance for improving patient outcomes. The use of preoperative NT-proBNP can provide a more precise assessment of the body's fluid load status, guide intraoperative and postoperative fluid management, and thus reduce fluid related postoperative complications. Given the potential association between ERAS and increased postoperative AKI, we hypothesize that preoperative NT-proBNP may be associated with the development of postoperative AKI in ERAS, and can improve the prediction of AKI beyond traditional clinical risk factors. This study aims to validate this hypothesis and provide evidence for using NT-proBNP to assess AKI risk before non cardiac surgery. Improve the predictive ability of clinical predictive models and optimize ERAS protocols to prevent postoperative AKI.
In the planned randomized controlled prospective pilot study, we aim to evaluate ADVOS compared with conventional hemodialysis regarding the elimination of protein-bound toxins in patients with therapy-refractory hepatorenal syndrome. The study will be performed in a regular non-ICU ward with a large experience in the use of the ADVOS therapy.
The goal of this observational study is to explore the value of Humanin for early diagnosis and short-term prognosis of AKI patients after heart transplantation. The main question it aims to answer are:whether Humanin can be a novel marker for predicting AKI after heart transplantation Researchers will compare the Humanin concentration in patients with AKI did not occur after heart transplantation to see if Humanin can be a novel marker for predicting AKI after heart transplantation
Septic shock is a syndrome characterized by tissue hypoperfusion and hypotension secondary to an uncontrolled infection. It is a frequent cause of admission to the intensive care unit (ICU) and has an associated mortality around 40%. Around 50 % of septic shock patients exhibit early acute kidney injury and 30 to 40% will require renal replacement therapy. After initial fluid resuscitation most of the patients with septic shock become hyperdynamic but still require norepinephrine (NE) to maintain a mean arterial pressure (MAP) above 65 mmHg. The optimal perfusion pressure may vary, specially in previously hypertensive patients as they may have a shift to the right in their kidney auto-regulatory curve. In a previous study in patients with chronic hypertension and septic shock, increasing MAP from 65 mmHg to 85 mmHg with NE was associated with improved renal function. However, the incidence of tachyarrhythmias increased, associated to the higher NE doses required, which has raised some concerns about the safety of this strategy. In this setting, the addition of vasopressin (AVP), a drug used as a vasopressor but with cathecholamine independent mechanisms, may allow to prevent this side effect by decreasing NE dose requirements. Low doses of AVP appear to be safe and when combined with NE in septic shock patients, it resulted in increased creatinine clearance and decreased use of renal replacement therapy, compared to NE alone. Theoretically, AVP can improve glomerular filtration rate. Therefore, the addition of AVP to NE in previously hypertensive septic shock patients should be a reasonable strategy to improve organ perfusion. Furthermore, AVP could be an important step towards decatecholaminization in the management of septic shock patients. However, its effect on cardiac performance and stroke volume when targeting high MAP is unclear.
SGLT2i have been shown to reduce risk for mortality, progression of chronic kidney disease, and cardiovascular outcomes in these populations. Yet, because SGLT2i can have an acute hemodynamic effect on kidney function, in clinical practice providers are wary of providing these medications to patients who have established indications but recently had acute kidney injury (AKI). This is a pilot interventional study to collect process-data (measures of recruitment and measures of adherence) that can be used to establish feasibility for a larger pilot randomized trial in the future. The study aims to conduct a small randomized intervention trial with two arms, with approximately 10-12 patients in the intervention arm and 5-6 in the control arm. The intervention will be providing a prescription for a SGLT2i based on established criteria for this FDA-approved class of drugs, and the control will be usual care (through which, control arm participants will also have access to this FDA-approved class of drugs - expect receipt of a SGLT2i in the control arm to be rare, but a degree of crossover will be expected).
The study aims to perform real-time validation of the RenaFAST kit (a point-of-care test kit that quantifies three urinary proteins) in predicting acute kidney injury(AKI) among patients prescribed drug therapies of nephrotoxic potential. Based on the type and duration of drug therapy, a maximum of 5 time-point urine samples will be collected from consenting patients and a real-time biomarker analysis will be conducted using the RenaFAST kits.