An Early Real-Time Electronic Health Record Risk Algorithm for the Prevention and Treatment of Acute Kidney Injury (ESTOP-AKI)

The University of Chicago

Status: Active, not recruiting

Conditions: Acute Kidney Injury

Treatments: Other: Early Nephrology Consult (ENC); Other: Standard of Care (SOC)

Study type: Interventional

Funder types: Other

Identifiers

NCT03590028

IRB17-1081

Details and patient eligibility

About

This is a single center randomized trial that seeks to determine if the use of an automated real-time electronic medical record Acute Kidney Injury (AKI) risk score can improve patient outcomes through the use of an early standardized nephrology focused intervention.

Enrollment: 180 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Age >18 years old
2. Initial ESTOP AKI score ≥0.01 within the last 8 hours.

Exclusion criteria

1. Voluntary refusal or missing written consent of the patient / legal representative.
2. Patients with a known history of end-stage renal disease on dialysis (including renal transplantation).
3. Patients without a measured serum creatinine value during their inpatient stay.
4. Patients with a creatinine >4.0 mg/dl at the time of admission or available in the electronic health record (EHR) from the last 6 months.
5. Patients with prior episode of Kidney Disease Improving Global Outcomes (KDIGO) defined AKI during this same hospitalization- regardless of ESTOP AKI score.
6. Patients with prior renal consultation during their admission.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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180 participants in 2 patient groups

Early Nephrology Consult (ENC)

Experimental group

Description:

The ENC will be a structured consultative note that will provide detailed recommendations around issues such as Differential Diagnosis, Drug Dosing and Volume Status. The research ENC will have a daily follow-up with documented recommendations.

Treatment:

Other: Early Nephrology Consult (ENC)

Standard of Care (SOC)

Active Comparator group

Description:

Subjects will receive nephrology consultation at the typical timepoint after symptoms of AKI appear.

Treatment:

Other: Standard of Care (SOC)