Tarek Samy Abdelaziz1, Ragai Fouda2, Wessam M Hussin3, Mohamed S Elyamny3, Yasser M Abdelhamid3. 1. Department of Internal Medicine, KasrAlainy Hospitals, Cairo University Hospitals, Cairo, Egypt. taroukah5070@kasralainy.edu.eg. 2. Medical ICU, KasrAlainy Hospitals, Cairo University Hospitals, Cairo, Egypt. 3. Department of Internal Medicine, KasrAlainy Hospitals, Cairo University Hospitals, Cairo, Egypt.
Abstract
BACKGROUND:Acute kidney injury (AKI) has significant impact on mortality and morbidity in critically ill patients. METHODS: A prospective controlled interventional pilot study composed of observation and intervention arms was run at two different Intensive care unit (ICU) sites. A recently validated risk prediction score was used to predict the AKI in critically ill patients at high risk of developing AKI. All patients with established AKI at the time of recruitment were excluded from the study. A package of early preventive measures, including an early nephrology review was applied to high risk patients in the intervention arm to prevent AKI development. RESULTS: We have recruited 108 patients at the intervention site and 98 patients at the observation site. The primary outcome measure was the AKI incidence. AKI incidence was significantly lower in the intervention arm than its incidence in the observation arm (11% vs 26%, p = 0.002). The median Time till recovery of AKI episodes was significantly lower in the intervention arm (3(1) vs. 5(2) days, p = 0.014) 0.30 day mortality was lower in the intervention arm, however, not statistically significant. CONCLUSION: Our pilot study showed that it was feasible to apply a simple risk score to implement early preventive measures to high risk patients, consequently, mitigating the risk of AKI development and reducing the time till recovery of AKI episodes. Multicentre studies are needed to confirm this favourable effect.
RCT Entities:
BACKGROUND:Acute kidney injury (AKI) has significant impact on mortality and morbidity in critically illpatients. METHODS: A prospective controlled interventional pilot study composed of observation and intervention arms was run at two different Intensive care unit (ICU) sites. A recently validated risk prediction score was used to predict the AKI in critically illpatients at high risk of developing AKI. All patients with established AKI at the time of recruitment were excluded from the study. A package of early preventive measures, including an early nephrology review was applied to high risk patients in the intervention arm to prevent AKI development. RESULTS: We have recruited 108 patients at the intervention site and 98 patients at the observation site. The primary outcome measure was the AKI incidence. AKI incidence was significantly lower in the intervention arm than its incidence in the observation arm (11% vs 26%, p = 0.002). The median Time till recovery of AKI episodes was significantly lower in the intervention arm (3(1) vs. 5(2) days, p = 0.014) 0.30 day mortality was lower in the intervention arm, however, not statistically significant. CONCLUSION: Our pilot study showed that it was feasible to apply a simple risk score to implement early preventive measures to high risk patients, consequently, mitigating the risk of AKI development and reducing the time till recovery of AKI episodes. Multicentre studies are needed to confirm this favourable effect.
Entities:
Keywords:
Acute kidney injury; Critically ill; Intensive care unit; Prediction
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