The goal of this clinical trial is to improve patient care after acute kidney injury (AKI). It has three related parts. The main questions it aims to answer are: 1. Is creatinine or cystatin a more reliable assessment of kidney function after AKI? 2. What are the experiences of patients after AKI? 3. What interventions should be recommended to improve assessment and support of patients after AKI? Participants will be asked to do one or more of: * blood tests to measure kidney function in different ways * have measurement of their body composition * complete questionnaires about their symptoms * have an interview with a researcher about their experiences * discussion to develop an action plan based on findings
Study Type
OBSERVATIONAL
Enrollment
100
Gold standard measurement of glomerular filtration rate.
Estimated GFR using serum cystatin C
eGFR from serum creatinine level
Semi structured interview to explore patient experiences. Purposive sampling will be used to explore a wide range of perspectives and transcripts will be analysed using thematic analysis to develop codes and themes.
Group workshop using qualitative methods. Purposive sampling will be used to explore a wide range of perspectives and transcripts will be analysed using thematic analysis to develop codes and themes. These will be used to develop consensus recommendations.
Analysis of the metagenome using faecal samples of participants after acute kidney injury
Estimation of body composition
EQ-5D-5L, KSQ, WHO-DAS 2.0, K10
Hand grip, Short physical performance battery
University Hospitals of Derby and Burton NHS Foundation Trust
Derby, Derbyshire, United Kingdom
RECRUITINGThe proportion of eligible patients who agree to participate
Time frame: 3 months
The proportion of participants who have all three measurements (eGFR-cystatin, eGFR-creatinine and measured GFR)
Time frame: 3 months
Standard deviation of the difference between measured GFR and eGFR-creatinine and eGFR-cystatin
Time frame: 3 months
The proportion of patients with eGFR <60ml/min/1.73m2 from eGFR-cystatin compared with eGFR creatinine
Time frame: 3 months
Gut microbiome composition
Assessed through metagenomics
Time frame: 3 months
Codes and themes related to patient experience after AKI, identified from systematic qualitative analysis of interview transcripts
Time frame: 3 - 12 months
Production of a document of recommended next steps through MDT development during participatory workshops
Time frame: At completion of third workshop 3 years after enrolment
The mean difference between eGFR-cystatin and eGFR-creatinine
Time frame: 3 months
The mean difference between iohexol measured GFR and each estimated GFR method (creatinine and cystatin)
Time frame: 3 months
Correlation between eGFR creatinine and eGFR cystatin
Time frame: 3 months
Correlation between iohexol measured GFR and each estimated GFR method (creatinine and cystatin)
Time frame: 3 months
Bias between iohexol measured GFR and each estimated GFR method (creatinine and cystatin)
Time frame: 3 months
Accuracy of eGFR creatinine and eGFR cystatin compared with iohexol measured GFR as assessed by the percentage of estimated values within 30% of measured GFR (P30)
Time frame: 3 months
Correlation of muscle mass with the percentage difference between eGFR-cystatin and eGFR-creatinine
Time frame: 3 months
Correlation of physical function with the percentage difference between eGFR-cystatin and eGFR-creatinine
Time frame: 3 months
Correlation of patient reported outcomes with the percentage difference between eGFR-cystatin and eGFR-creatinine
Time frame: 3 months
Barriers to implementation of recommendations as identified through MDT discussion at participatory workshops
Time frame: At completion of third workshop 3 years after enrolment
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