Acute Kidney Outreach to Reduce Deterioration and Death (AKORDD)
This trial is active, not recruiting.
|Condition||acute kidney injury|
|Treatments||rapid diagnosis of aki cause, rapid treatment of aki cause, stopping 'nephrotoxic' drugs, early nephrology followup for stage 3 aki, preventing recurrent aki, good standard care|
|Sponsor||Heart of England NHS Trust|
|Collaborator||University of Birmingham|
|Start date||October 2014|
|End date||May 2016|
|Trial size||1800 participants|
|Trial identifier||NCT02398682, PB-PG-1111-26038|
The study pilots an outreach service for Acute kidney injury (AKI) patients, based on electronic alerts. Using the alerts we will contact the primary clinician caring for the patient with AKI in the Intervention group. The study has a control group of patients receiving good standard care, but without Outreach. The aim is to reduce morbidity and mortality in the syndrome, and also to reduce healthcare costs.
|Endpoint classification||efficacy study|
|Intervention model||parallel assignment|
|Primary purpose||health services research|
Composite measure of participants not alive, need for dialysis, or progression of AKI stage
time frame: within 30 days
Male or female participants at least 18 years old.
Inclusion Criteria: - adult patients with an Alert for AKI issued in accordance with the national algorithm for AKI alerts (NHS England) - AKI stage 2 or 3 (this criterion is under review during the preparatory phase of the study) Exclusion Criteria: - patients already on dialysis for AKI at the time of alert - patients with End stage renal disease - patients <18 years of age - patients with no evidence of AKI on review of the automated Alert - patients dissenting from participation according to the Ethics application
|Official title||Acute Kidney Outreach to Reduce Deterioration and Death (AKORDD) - A Pilot Study to Look at Enhancing Patient Care, Improving Patient Outcomes and Reducing NHS Costs|
|Principal investigator||Mark Thomas, FRCP|
|Description||Lay summary: About one in six hospital inpatients suffer Acute Kidney Injury (AKI), also called acute renal failure. About a third of patients with AKI die. The large majority of patients with AKI are managed by doctors who are not kidney experts. Effective AKI advice and treatments are available but not currently integrated into routine care. A recent National review of the care of patients who died from AKI showed poor management of many patients. Early diagnosis of AKI can avoid complications, dialysis (which affects the quality of life of patients, and is costly) or death. AKI is diagnosed by a change in a blood test. We have developed computer software to diagnose AKI earlier. It sends a warning or 'Alert' about the test to our team of kidney experts. We will further develop the settings of the Alert system. It needs to send an Alert for the right patients. We will also study the best way to make clinicians pay attention to their patients who are developing AKI. When our expert Outreach team receive an Alert, they will call the doctor or nurse looking after the patient with AKI. We will advise on the best treatment for that patient, to reduce their risk of death, dialysis and other complications. We will do a pilot study in one large hospital, to further develop the system, and check it reduces the risk of death or complications from AKI. We will use this work to develop a larger trial of this new system of care for patients with AKI in different hospitals. This will convince the wider NHS of the need to change, and show how to prevent or reduce AKI. Ultimately we aim to improve patients' lives by reducing avoidable death and illness from AKI , and also save the NHS money.|
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