Extrait

Background and study aims Acute kidney injury (AKI) is sudden and severe damage to the kidneys that stops them working properly. AKI is a common complication for patients who are having major surgery, affecting as many as one in five people. In many cases, the decrease in kidney function does not last for long and so the problem could resolve itself without the doctor or the patient being aware of it. For this reason, it is often missed as the problem can only really be identified using specific medical tests. Recent studies have shown however, that patients who experience even mild AKI are likely to have longer hospital stays and have a greater chance of dying within the first few weeks after surgery. Importantly, as patients recover, kidney blood tests often return to normal even if the kidneys have been permanently damaged. These patients may be at risk of chronic (long-term) kidney disease over time, increasing their risk of severe heart disease, high blood pressure and permanent kidney failure needing dialysis. The aim of this study is to find out how common AKI is after major surgery and its long-term consequences for patients' kidney function, general health and well-being. Who can participate? Adults over 45 years of age who are undergoing major surgery (except heart surgery) by choice. What does the study involve? Patients having major surgery who have agreed to take part in the study have blood and urine samples taken before their operation in order to test for signs of any long-term kidney problems (chronic kidney disease). These samples are also taken 1, 3, 5 and 7 days after surgery, in order to test for signs of any new kidney problems (acute kidney injury). Patients who have been identified as suffering from chronic kidney disease (CKD) at the start of the study, those suffering from acute kidney injury (AKI) as well as randomly selected patients with normal kidney function are invited for follow up appointments at 30 and 365 days after surgery. At these appointments, further blood and urine samples are taken as well as having their glomerular filtration rate measured (a medical test where a substance is injected into the blood to measure how quickly the kidneys manage to remove it from the body (through urine production)). What are the possible benefits and risks of participating? Patients taking part in the study may benefit from more detailed healthcare screening and monitoring after they are discharged from hospital. There is a risk of bruising, pain and discomfort from the blood testing. Also, participants may have to attend extra hospital appointments for monitoring, which could be an inconvenience. Where is the study run from? The Royal London Hospital (UK) When is the study starting and how long is it expected to run for? January 2015 to December 2018 Who is funding the study? National Institute for Health Research (UK) Who is the main contact? 1. Mr Richard Haslop (public) 2. Dr John Prowle (scientific)

Critère d'inclusion

• acute kidney injury

Liens

• isrctn
• ictrp