The goal of this observational study is to learn the epidemiology and outcomes of acute kidney injury in critically ill adult patients admited to the intensive care unit (ICU). The main questions it aims to answer are:To provide a contemporary update on the epidemiology (rates, severity, duration, and etiology) of acute kidney injury and associated outcomes in critically ill patients. The co-primary outcomes are: * occurrence rate of acute kidney injury within 7 days of ICU admission * maximum severity of acute kidney injury within 7 days of ICU admission. Secondary outcomes: * Proportion of acute kidney injury in patients with and without known baseline serum creatinine * Duration of acute kidney injury episodes (within first week of ICU admission) * Proportion of episodes with rapid reversal (duration \<48h) versus persistent acute kidney injury (duration ≥48h) * Incidence of acute kidney disease at ICU discharge and hospital discharge, truncated at 90-d * Use of Renal Replacement Therapy within 7 days of ICU admission * Type and specifics of applied Renal Replacement Therapy (indications, timing, modality, method duration, anticoagulation, discontinuation) * ICU lenght of stay (ICU LOS), Hospital lenght of stay (Hospital LOS) * ICU readmission up to day 90 * Hospital readmission up to day 90 * Serum creatinine level at ICU and hospital discharge (truncated at day 90) * RRT dependence at hospital discharge (any RRT applied within 72 hours of discharge) * Mortality at hospital discharge (truncated at 90-d) * Magnitude of acute kidney injury: area under the curve of acute kidney injury severity over time * Incidence of acute kidney injury and maximum acute kidney injury severity stage defined by serum creatinine and/or urine output criteria only, within 7 days of ICU admission. Additional endpoints for patients included in the "long term outcomes substudy": * Serum creatinine level at day 90, and 1 y * Renal Replacement Therapy dependence at day 90, and 1y * Mortality at hospital discharge at day 90, and 1y * Survival analysis up to day 90 and 1 y * Health-related quality of life at day 90 and 1y * Major Adverse Kidney Events (MAKE): a composite endpoint of death, use of Renal Replacement Therapy and decreased kidney function at day 90, and 1 year.
Study Type
OBSERVATIONAL
Enrollment
10,642
Ghent University Hospital
Ghent, Belgium
occurrence rate of acute kidney injury
occurrence rate of acute kidney injury in adult patients admitted to the ICU and defined by the Kidney Disease: Improving Global Outcomes defintion
Time frame: within 7 days of ICU admission
maximum severity of acute kidney injury
maximum severity of acute kidney injury defined by the Kidney Disease: Improving Global Outcomes classification
Time frame: within 7 days of ICU admission.
Proportion of acute kidney injury in patients with and without known baseline serum creatinine
acute kidney injury as defined by the Kidney Disease: Improving Global Outcomes definition in patients with known baseline serum creatinine and in those without known baseline serum creatinine
Time frame: within 7 days of ICU admission.
Duration of acute kidney injury episodes
acute kidney injury defined by the Kidney Disease: Improving Global Outcomes definition, and duration measured in days
Time frame: within 7 days of ICU admission.
Proportion of episodes with rapid reversal (duration <48h) and persistent acute kidney injury(duration ≥48h)
acute kidney injury defined by the Kidney Disease: Improving Global Outcomes definition
Time frame: within 7 days of ICU admission.
Incidence of acute kidney disease
acute kidney disease as defined by the Kidney Disease: Improving Global Outcomes definition
Time frame: at ICU discharge and at hospital discharge, or at 90-days in case hospital admission is longer than 90 days.
Use of renal replacement therapy within 7 days of ICU admission
Time frame: within 7 days of ICU admission.
Type and specifics of applied renal replacement therapy
indications, timing, modality, method duration, anticoagulation, discontinuation
Time frame: within 7 days of ICU admission.
Length of stay
Length of stay in the ICU, post ICU in the hospital, and total length of stay in the hospital , measured in days
Time frame: hospital stay
ICU readmission up to day 90
Time frame: within 90 days of ICU admission
Hospital readmission up to day 90
Time frame: within 90 days of ICU admission
Serum creatinine level at ICU and hospital discharge (truncated at day 90)
Time frame: at discharge of the ICU and of the hospital, or day 90 after ICU admission if hospital stay is longer than 90 days after ICU admission
Renal Replacement Therapy dependence at hospital discharge
Renal Replacement Therapy dependence is defined as the use of renal replacement therapy within 72-hours before hospital discharge
Time frame: hospital discharge
Mortality
Time frame: at hospital discharge or at day 90 after ICU admission if hospital stay is longer than 90 days after ICU admission
Magnitude of acute kidney injury
Magnitude of acute kidney injury: defined as the area under the curve of acute kidney injury severity over time
Time frame: within 7 days of ICU admission.
Incidence of acute kidney injury and maximum acute kidney injury severity stage defined by serum creatinine criteria only and urine output criteria only
acute kidney injury is defined and classified by the Kidney Disease: Improving Global Outcomes definition
Time frame: within 7 days of ICU admission.
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