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Preventing acute kidney injury and improving outcome in critically ill patients utilizing risk prediction score (PRAIOC-RISKS) study. A prospective controlled trial of AKI prevention

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Abstract

Background

Acute kidney injury (AKI) has significant impact on mortality and morbidity in critically ill patients.

Methods

A prospective controlled interventional pilot study composed of observation and intervention arms was run at two different Intensive care unit (ICU) sites. A recently validated risk prediction score was used to predict the AKI in critically ill patients at high risk of developing AKI. All patients with established AKI at the time of recruitment were excluded from the study. A package of early preventive measures, including an early nephrology review was applied to high risk patients in the intervention arm to prevent AKI development.

Results

We have recruited 108 patients at the intervention site and 98 patients at the observation site. The primary outcome measure was the AKI incidence. AKI incidence was significantly lower in the intervention arm than its incidence in the observation arm (11% vs 26%, p = 0.002). The median Time till recovery of AKI episodes was significantly lower in the intervention arm (3(1) vs. 5(2) days, p = 0.014) 0.30 day mortality was lower in the intervention arm, however, not statistically significant.

Conclusion

Our pilot study showed that it was feasible to apply a simple risk score to implement early preventive measures to high risk patients, consequently, mitigating the risk of AKI development and reducing the time till recovery of AKI episodes. Multicentre studies are needed to confirm this favourable effect.

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Funding

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Authors and Affiliations

  1. Department of Internal Medicine, KasrAlainy Hospitals, Cairo University Hospitals, Cairo, Egypt

    Tarek Samy Abdelaziz, Wessam M. Hussin, Mohamed S. Elyamny & Yasser M. Abdelhamid

  2. Medical ICU, KasrAlainy Hospitals, Cairo University Hospitals, Cairo, Egypt

    Ragai Fouda

Authors
  1. Tarek Samy Abdelaziz
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  2. Ragai Fouda
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  3. Wessam M. Hussin
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  4. Mohamed S. Elyamny
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  5. Yasser M. Abdelhamid
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Corresponding author

Correspondence to Tarek Samy Abdelaziz.

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Conflict of interests

The authors declare no conflict of interests.

Ethical approval

The study protocol was approved by Kasr-Alainy Ethics Committee. The study was conducted in line with Declaration of Helsinki.

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Abdelaziz, T.S., Fouda, R., Hussin, W.M. et al. Preventing acute kidney injury and improving outcome in critically ill patients utilizing risk prediction score (PRAIOC-RISKS) study. A prospective controlled trial of AKI prevention. J Nephrol 33, 325–334 (2020). https://doi.org/10.1007/s40620-019-00671-6

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  • DOI: https://doi.org/10.1007/s40620-019-00671-6

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