Improving Patient Assessment After Acute Kidney Injury (AKI)

Improving Patient Assessment After Acute Kidney Injury (AKI)

The goal of this clinical trial is to improve patient care after acute kidney injury (AKI). It has three related parts. The main questions it aims to answer are:

1. Is creatinine or cystatin a more reliable assessment of kidney function after AKI?
2. What are the experiences of patients after AKI?
3. What interventions should be recommended to improve assessment and support of patients after AKI?

Participants will be asked to do one or more of:

• blood tests to measure kidney function in different ways
• have measurement of their body composition
• complete questionnaires about their symptoms
• have an interview with a researcher about their experiences
• discussion to develop an action plan based on findings

Inclusion Criteria:

Observational study workstream

• Age 18-85 years
• AKI stage 2 or 3 during hospital admission OR AKI stage 1 of at least 7 days duration during hospital admission
• 60-90 days after peak creatinine Qualitative interview workstream
• Age 18-85 years
• AKI during hospital admission
• 60-90 days after peak creatinine Participatory workshop workstream
• Age 18-85 years
• Relevant experience (as assessed by the investigator) which could include personal experience of an episode of hospitalised AKI as a patient of carer, experience of managing AKI or related problems in a professional capacity or knowledge of a particular community.

Exclusion Criteria:

Observational study workstream

• Inability to give informed consent
• No baseline creatinine available in previous 12 months
• Pregnancy or breastfeeding
• Current treatment with dialysis
• Renal transplant
• Pacemaker in situ
• Previous amputation
• Allergy to Omnipaque contrast agent (WP1 only)
• Manifest thyrotoxicosis (WP1 only)
• Ascites or significant (grade 3 to 4) peripheral oedema, defined as ≥6 mm pit, lasting for >1 minute after 5-second compression over tibia or medial malleolus (WP1 only) Qualitative interview workstream
• Inability to give informed consent
• No baseline creatinine available in previous 12 months
• Current treatment with dialysis
• Renal transplant
• Receiving palliative care Participatory workshop workstream
• Inability to give informed consent
• Inability to communicate in English (the qualitative workshops will be held in English)