Ultrasound Markers of Organ Congestion in Severe Acute Kidney Injury

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

125 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-09-04

Study Completion Date

2022-09-01

Brief Summary

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Fluid overload is associated with adverse outcomes in patients with severe acute kidney injury. It remains unclear if fluid overload is merely a marker of disease severity or if organ congestion is a mediator of complications. Point-of-care ultrasound could be a modality used to assess organ congestion and its clinical implications. The objective of this study is to determine whether ultrasound markers of organ congestion are associated with major adverse kidney events in critically ill patients with severe acute kidney injury.

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Detailed Description

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Background: Fluid overload is associated with adverse outcomes in patients with severe acute kidney injury. It remains unclear if fluid overload is merely a marker of disease severity or if organ congestion is a direct mediator of complications. Point-of-care ultrasound could be a modality used to assess organ congestion and its clinical implications.

Objective: To determine whether ultrasound markers of organ congestions are associated with major adverse kidney events and other adverse clinical outcomes.

Study design: A cohort of critically ill patients with a new onset of severe acute kidney injury will undergo repeated ultrasound assessments to detect the presence of the following markers:

* Portal flow pulsatility on pulse-wave Doppler
* Discontinuous intra-renal venous flow on pulse-wave Doppler
* Abnormal hepatic vein waveform on pulse wave Doppler
* Presence of pulmonary B-line artifacts on 2D lung ultrasound
* Presence of dilated and non-collapsible inferior vena cava on 2D ultrasound
* Presence of systolic right ventricular dysfunction
* Presence of systolic left ventricular dysfunction

Clinical outcomes will be collected for up to 90 days after recruitment.

Perspective: An approach targeting the resolution of organ congestion might improve the prognosis in patients with severe acute kidney injury. Identifying clinically relevant markers of organ congestion is a precursor to the design of future interventional trials investigating personalized fluid balance management.

Conditions

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Acute Kidney Injury Fluid Overload Ultrasonography

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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New onset of stage ≥2 acute kidney injury

Either:

1. A ≥ 2-fold increase in serum creatinine OR
2. A serum creatinine ≥ 354 μmol/L with evidence of a minimum increase of 27 μmol/L OR
3. Urine output \< 6.0 mL/kg over the preceding 12 hours OR
4. Initiation of RRT for severe acute kidney injury less than 72 hours before recruitment