AKI Biomarkers in Coronavirus(COVID)-19

  • STATUS
    Recruiting
  • participants needed
    30
  • sponsor
    Guy's and St Thomas' NHS Foundation Trust
Updated on 5 August 2020
critical illness
acute renal failure
coronavirus
respiratory disorder
covid-19
renal injury
acute kidney injury
cardiac arrest
critically ill
coronavirus infection

Summary

This research aims to investigate the role of daily measurement of urinary cell cycle arrest markers and other serum and urinary biomarkers to predict the development of acute kidney injury in critically ill patients with COVID-19 and acute respiratory disease.

Description

COVID-19 is a rapidly evolving pandemic with approximately 5% of all patients requiring admission to an intensive care unit. In critically ill patients with COVID-19, acute respiratory disease and acute kidney injury (AKI) are very common. Patients with AKI have an increased risk of mortality, especially renal replacement therapy (RRT) is required. The latest Intensive Care National Audit & Research Centre (ICNARC) report shows a 77% ICU mortality in patients with COVID-19 who require mechanical ventilation and RRT.

COVID-19 associated AKI is still poorly understood. The exact underlying pathophysiology remains unknown. Furthermore, there are no specific strategies to prevent or treat AKI. Management is supportive consisting of fluid and haemodynamic optimization, discontinuation of nephrotoxic drugs and prevention of nephrotoxic exposures. Ideally, AKI needs to be recognized as early as possible for these supportive measures to be effective.

Early prediction of AKI may be valuable to optimize management and improve outcomes. In critically ill patients without COVID-19, the two cell-cycle arrest markers, tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth-factor binding protein 7 (IGFBP7), have been shown to predict the development of AKI. Whether these new biomarkers also predict the development of AKI in critically ill patients with COVID-19 is unknown.

The aim of this project is to explore whether urinary cell cycle arrest markers and other renal biomarkers have a role in predicting AKI in critically ill patients with COVID-19 and acute respiratory disease. The results will advance the understanding of this disease and serve to develop strategies for individualized management of this high-risk group.

Details
Condition Renal Failure, Renal Failure, Acute renal failure, Acute Respiratory Failure, COVID
Age 18years - 100years
Clinical Study IdentifierNCT04408248
SponsorGuy's and St Thomas' NHS Foundation Trust
Last Modified on5 August 2020

Eligibility

Yes No Not Sure

Inclusion Criteria

Moderate or severe respiratory disease as defined by Berlin criteria
COVID-19 positive
Age 18 years

Exclusion Criteria

pre-existing AKI
severe chronic kidney disease (CKD) with estimated glomerular filtration rate (eGFR) <20ml/min
end-stage renal failure on regular dialysis
kidney transplant within the last 12 months
pregnancy
breastfeeding
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