Acute Kidney Injury (AKI) outcome study
Research type
Research Study
Full title
Acute Kidney Injury (AKI) outcome study: A prospective cohort study to investigate the value of biomarkers in predicting adverse outcomes following acute kidney injury
IRAS ID
243910
Contact name
Tony Bjourson
Contact email
Sponsor organisation
Ulster University
Duration of Study in the UK
3 years, 6 months, 31 days
Research summary
Acute kidney injury (AKI) is a sudden deterioration of kidney function that causes them not to work properly. One of the major causes of AKI is a reduced blood flow to the kidneys due to bleeding, diarrhoea, heart failure, inflammation of the blood vessels within the kidneys or the use of certain medicines. Other causes such as infections, enlarged prostate or kidney stones might also result in AKI. \n\nAKI is a major complication in hospitalised patients that could eventually lead to long-term complications such as chronic kidney disease, the need for renal replacement therapy and death. Currently, there is no test that can predict who is more susceptible to such complications. Therefore, there is a great need to identify individuals at higher risk of adverse outcomes following an AKI in order to manage them more efficiently and to prevent the complications.\n\nIn current practice, AKI diagnosis is based on the measurement of creatinine which is a protein produced at a constant rate by the muscles. The measurement of creatinine is then used to calculate the glomerular filtration rate (GFR) which describes the flow rate or filtered fluid through the kidneys. If the GFR is below 60 ml/min, this indicates a deteriorating kidney function. \nHowever, despite the widespread use of creatinine as an indicator of kidney damage, many issues have been highlighted when it comes to its specificity and sensitivity. Creatinine is known to rise only after significant kidney injury and with a substantial time delay. For this reason, many other proteins have been proposed as an alternative or in addition to creatinine measurement in order to properly assess the extent of kidney damage. Each of these proteins demonstrated a possible clinical utility in separate studies. However, none are currently used in clinical practice. Therefore, novel AKI markers need to be investigated.\n \nOne of the major complications of AKI is chronic kidney disease (CKD). CKD is a long-term condition characterized by a gradual loss of kidney function over a period of months or years. CKD is common, frequently unrecognized and often exists together with other conditions such as cardiovascular disease and diabetes.\n\nThe proposed study is part of a PhD project. The aim of this study is to investigate the clinical value of biomarkers (such as blood and urinary markers and genetic markers) in predicting adverse outcomes following an AKI. The secondary aim is to identify novel markers of kidney injury that are specific to the initial cause of the kidney damage. To do this we will conduct a prospective cohort study to investigate whether a set of markers are associated with adverse outcomes after AKI. These markers will be compared across individuals admitted with AKI, apparently healthy individuals as well as individuals with CKD. In addition, by comparing individuals admitted with AKI to apparently healthy individuals, we aim to identify novel AKI markers. This could lead to the implementation of novel clinical decision tools that will better identify who is at higher risk of AKI as well as who is more likely to develop adverse outcomes following AKI. \n
REC name
North of Scotland Research Ethics Committee 1
REC reference
18/NS/0067
Date of REC Opinion
7 Jun 2018
REC opinion
Further Information Favourable Opinion