Acute Kidney Outreach to Reduce Deterioration and Death (AKORDD)

Summary

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.

Conditions

• Acute Kidney Injury

Interventions

OTHER

Rapid diagnosis of AKI cause

The Outreach team will advise on an evidence-based package of care: 1\) Rapidly establish a credible diagnosis of the cause of AKI including: 1. Improved assessment of volume status 2. Standardised use of urine dipstick . 3. Appropriate sepsis investigations. 4. Urgent ultrasound with suspected obstruction.

OTHER

Rapid treatment of AKI cause

Rapid, limited treatment of hypovolaemia, with avoidance of iatrogenic fluid overload, recently recognised as a significant cause of mortality in AKI. Rapid sepsis therapy. Urgent relief of urinary tract obstruction.

OTHER

Stopping 'nephrotoxic' drugs

Cessation of all potentially nephrotoxic drugs.

OTHER

Early nephrology followup for stage 3 AKI

A rapid followup at discharge in an AKI clinic for survivors of stage 3 AKI, within 7 days of discharge for those in hospital, or within 7 days of the Alert for those not admitted to hospital.

OTHER

Preventing recurrent AKI

Patients with AKI in the Intervention arm will receive information on preventing AKI during the study.

OTHER

Good standard care

Good standard care will be provided for all patients in non Experimental arms; clinicians will continue to be able to rapidly refer patients for Nephrology advice or review; online guidance will be available for all clinicians and noted in the alerts for all cases of AKI.

Sponsors & Collaborators

• University of Birmingham

  collaborator OTHER

• University of Warwick

  collaborator OTHER

• Heart of England NHS Trust

  lead OTHER

Principal Investigators

• Mark Thomas, FRCP · Heart of England NHS Trust

Study Design

Allocation

NON_RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2014-10-31

Primary Completion

2017-05-31

Completion

2017-05-31

Countries

• United Kingdom

Study Locations