Prevention of Postoperative Acute Kidney Injury

Wuerzburg University Hospital

Overview

Postoperative acute kidney injury (AKI) refers to increased mortality and morbidity in patients after non-cardiac surgery. The Kidney Disease Improving Global Outcomes (KDIGO)-guidelines recommend a bundle of procedures to prevent the occurrence of AKI: A protocol for the improvement of the hemodynamic situation and a standardized proceeding in hemodynamic monitoring, consequent avoidance of nephrotoxic substances, regular measurement of creatinine and urine output, as well as normoglycemia. The primary goal is to determine if the consequent application of the KDIGO-bundle leads to a prevention of the occurrence of AKI in patients at risk after non-cardiac surgery.

All patients included in the study will be treated with the KDIGO-bundle (hemodynamic stabilization, avoidance of nephrotoxic substances, normoglycemia and measurement of creatinine in serum and urine output). 12 h, 24h as well as on day 2, 3, 5 and 10 after admission on ICU the occurence of AKI (according to KDIGO) will be assessed.

Study Type

INTERVENTIONAL

Allocation

Purpose

PREVENTION

Masking

NONE

Conditions

Acute Kidney Injury

Interventions

kidney treatment bundle (KDIGO)PROCEDURE

Application of the measures of the kidney treatment bundle.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion criteria: * Age \> 65 years * chronic kidney disease * diabetes mellitus, chronic heart, lung or liver disease * hemodynamic instability (intra and/or post-operative) * trauma, burn injury, major surgery, usage of x-ray contrast and sepsis. Exclusion criteria: * Age \< 18 years * pregnancy * kidney graft recipient * chronic renal disease with or without renal replacement therapy and cardiac surgery.

Locations (1)

University Hospital Wuerzburg, Dep. of Anesthesiology

Würzburg, Germany

Outcomes

Primary Outcomes

Incidence of postoperative AKI

AKI according to KDIGO definition

Time frame: until day 5 after surgery

Secondary Outcomes

Intensive care unit mortality

Time frame: 28 days and 90 days after surgery

hospital mortality

Time frame: up to 100 days after surgery

usage of renal replacement therapy (hours)

Time frame: up to 30 days after surgery

length of invasive respirator therapy (hours)

Time frame: up to 30 days after surgery

creatinine in serum

Time frame: 12 hours, day 2, 3, 5 and 10 after surgery

urine output (total ml)

Time frame: after 12 hours, on day 2 (in 24hour), 3 (in 24hour), 5 (in 24hour) and 10 (in 24hour) after surgery

length of hospital stay

Time frame: up to 100 days after surgery

length of ICU stay

Time frame: up to 100 days after surgery

Data from ClinicalTrials.gov

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