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| Name | Class |
|---|---|
| National Health Research Institutes, Taiwan | OTHER |
| Taipei Medical University | OTHER |
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Strategies to stop AKI-AKD-CKD continuum - Policy is one of the collaborative projects, Strategies to stop AKI-AKD-CKD continuum, Epidemiology, Immunology, Repair, Artificial intelligence, and Policy (EIRAP). It is aimed to study effective interventional strategies that lower the incidence of CKD among patients with AKD. The intensified AKD care to reduce CKD (ISACC trial) is a prospective, open-labeled, randomized controlled trial is designed to evaluate the efficacy of multidisciplinary team care (MDT) model and acute kidney disease (AKD) clinic visits
Acute kidney disease (AKD), defined as the ongoing renal function impairment between 7 days and 90 days following AKI, has been proposed as a window of intervention to prevent the occurrence of CKD. However, the effective therapeutic strategies of AKD care remain to be developed. We intend to conduct a prospective, randomized, open-label, behavioral interventional trial to validate the efficacy of multidisciplinary team (MDT) care model which aims to improve AKD care and to reduce de novo CKD incidence.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intensified care | Experimental | Experimental: Multidisciplinary team (MDT) care + Acute kidney disease (AKD) clinic Participants randomized to this arm will receive multidisciplinary team (MDT) care by a specialized medical team which is composed of nephrologist, pharmacist and dietitian. Besides intensified care, participants of this arm receive evaluation of biochemical and physiological renal function more frequently. In order to provide seamless care of this group, post-discharge acute kidney disease (AKD) clinic will also be arranged for them. Clinic visits consist of evaluation of renal function, reconciliation of medication and steering necessity of renal replacement therapy. |
|
| Usual care | No Intervention | No intervention: Usual care Participants randomized to this arm will receive usual care according to the medical decisions of principal care physician. Nephrologist consultation and nephrology outpatient clinic follow-up will be allowed. However, this group of patient will not have access to MDT care and AKD clinic. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multidisciplinary team (MDT) care and Acute kidney disease (AKD) clinic | Behavioral | Multidisciplinary team (MDT) care: NPDS care model Acute kidney disease (AKD) clinic: layered approach |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Major adverse kidney event | Proportion of MAKE
| 90days |
| Measure | Description | Time Frame |
|---|---|---|
| Mortality | Proportion of death | 30days, 60days, 90days, 180days, 360 days, 3years |
| Chronic dialysis | Proportion of chronic dialysis | 90days, 180days, 360 days, 3years |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mai-Szu Wu, MD | Contact | +886-2-22490088 | maiszuwu@gmail.com | |
| Yu-Wei Chen, MD | Contact | +886-2-22490088 | 2717 | b101091063@tmu.edu.tw |
| Name | Affiliation | Role |
|---|---|---|
| Mai-Szu Wu | Shuang Ho Hospital, Taipei Medical University | Study Chair |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28239173 | Background | Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, Bittleman D, Cruz D, Endre Z, Fitzgerald RL, Forni L, Kane-Gill SL, Hoste E, Koyner J, Liu KD, Macedo E, Mehta R, Murray P, Nadim M, Ostermann M, Palevsky PM, Pannu N, Rosner M, Wald R, Zarbock A, Ronco C, Kellum JA; Acute Disease Quality Initiative Workgroup 16.. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup. Nat Rev Nephrol. 2017 Apr;13(4):241-257. doi: 10.1038/nrneph.2017.2. Epub 2017 Feb 27. | |
| 30473140 |
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Undecided
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| ID | Term |
|---|---|
| D058186 | Acute Kidney Injury |
| D051436 | Renal Insufficiency, Chronic |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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| ID | Term |
|---|---|
| D000554 | Ambulatory Care Facilities |
| ID | Term |
|---|---|
| D006268 | Health Facilities |
| D005159 | Health Care Facilities Workforce and Services |
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| Renal progression | Proportion of renal progression to CKD | 90days, 180days, 360 days, 3years |
| Time to MAKE | Time to MAKE | 90days, 180days, 1year (360days) |
| Time to death | Time to death | 90days, 180days, 1year (360days) |
| Time to chronic dialysis | Time to chronic dialysis | 90days, 180days, 1year (360days) |
| Time to renal progression to CKD | Time to renal progression to CKD | 90days, 180days, 1year (360days) |
| Time to first ER visit | Time to first ER visit | 90days, 180days, 1year (360days) |
| Time to first rehospitalization | Time to first rehospitalization | 90days, 180days, 1year (360days) |
| Time to first recurrence of AKI | Time to first recurrence of AKI | 90days, 180days, 1year (360days) |
| Proportion of MACE | CVA, AMI, CHF, or cardiac revascularization procedure | 30days, 60days, 90days, 180days, 360 days, 3years |
| Background |
| See EJ, Jayasinghe K, Glassford N, Bailey M, Johnson DW, Polkinghorne KR, Toussaint ND, Bellomo R. Long-term risk of adverse outcomes after acute kidney injury: a systematic review and meta-analysis of cohort studies using consensus definitions of exposure. Kidney Int. 2019 Jan;95(1):160-172. doi: 10.1016/j.kint.2018.08.036. Epub 2018 Nov 23. |
| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |