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Trial registered on ANZCTR
Registration number
ACTRN12610001012066
Ethics application status
Approved
Date submitted
12/02/2010
Date registered
18/11/2010
Date last updated
19/11/2010
Type of registration
Retrospectively registered
Titles & IDs
Public title
Early Detection of Acute Kidney Injury (EDAKI)
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Scientific title
Early Detection of Acute Kidney Injury with Neutrophil Gelatinase Associated Lipocalin, Gamma-Glutamyl Transpeptidase, Albumin, Neopterin, Dihydroneopterin and other biomarkers: Reduction in false negative rates (EDAKI)
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Secondary ID [1]
253109
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None
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Universal Trial Number (UTN)
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Trial acronym
EDAKI
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute Kidney Injury
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Acute Renal Failure
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Cardiac Arrest
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Abdominal Aortic Aneurysm
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Hypotension
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Condition category
Condition code
Renal and Urogenital
252192
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0
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Kidney disease
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
No intervention. Prospective observational study of urinary and plasma biomarkers in the emergency department, intensive care unit, and at a 30 day follow up. Mortality will be assessed at one year.
Urinary biomarkers are taken from urine collected from catheterised patients in the Emergency Department, on entry to the Intensive Care Unit, then 4, 8, 16 hours, and 2, 4, 7 days later. There is no inconvenience to patients.
Plasma biomarkers are taken from blood sampled at the same time points, with the exception of the 4 and 8 hour samples, these samples are taken along with routine clinical blood collections. There is minimal inconvenience to patients.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
Comparator's are patients without Acute Kidney Injury
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Control group
Active
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Outcomes
Primary outcome [1]
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Reduction of False Negative rate for prediction of Acute Kidney Injury (AKI) by sampling on entry to the Emergency Department (ED) compared with on entry to the Intensive Care Unit (ICU)
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Assessment method [1]
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Timepoint [1]
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Comparison between on entry to ED compared with on entry to ICU
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Secondary outcome [1]
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Receiver Operator Characteristic (ROC) plot analysis ("receiver-operating characteristic") will be used to compare the discriminative power of the biomarkers for AKI, need for Renal Replacement Therapy (RRT), Death (30 day).
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Assessment method [1]
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Timepoint [1]
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On entry to ED. On entry to the ICU. During ICU stay (7 days)
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Eligibility
Key inclusion criteria
On entry to the ED:
(1) Cardiac Arrest within the preceding three hours AND/OR
(2) Ruptured Abdominal Aortic Aneurysm AND/OR
(3) Sustained hypotension (defined as systolic blood pressure (SBP) <90 mmHg or Mean Arterial Pressure (MAP) < 65 mmHg after 1000ml IV fluid challenge / 60 mins (including Intravenous (IV) fluids pre hospital)) AND/OR
(4) Profound hypotension (Systolic Blood Pressue (SBP) less than 60mmHg) of any duration.
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(1) Age<16
(2) Moribund, not expected to survive 24 hours
(3) Likely to be discharged within 24 hours
(4) Drug overdose
(5) Treatment limitation order
(6) Receiving Renal Replacement Therapy
(7) More than 4 hours since entry to ED
(8) Inter-hospital transfer unless arrival in ED within <3 hours of event
(9) Non-consent
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
8/03/2010
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Canterbury
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Lotteries Health New Zealand
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Address [1]
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Lottery Health Research,
Department of Internal Affairs,
46 Waring Taylor Street,
PO Box 805,
Wellington,
New Zealand.
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
University of Otago Christchurch
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Address
PO Box 4345
Christchurch 8140
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
255829
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Upper South B Regional Ethics Committee
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Ethics committee address [1]
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c/- Ministry of Health PO Box 3877 Christchurch 8140
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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07/10/2009
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Ethics approval number [1]
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URA/09/09/062
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Summary
Brief summary
Lay Summary: Acute Kidney Injury (AKI) occures in nearly half of all critically ill patients because of temporary loss of blood to the kidneys or damage from toxins. Currently AKI is diagnosed by observing creatinine in the blood which increases in concentration 2-3 days after injury. This delay in treatment can be fatal. This study measures new biomarkers of AKI which indicate damage to the kidney within a few hours of injury. Each biomarker reacts differently and tells us something different about the injury. For example, albumin comes from the blood into the kidneys and out into the urine only when the filter mechanism is damaged. GGT and NGAL are elevated in urine when there is specific damage to the tubules in which urine is formed in the kidney and neopterin tells us if there is inflammation in these tubules. By measuring these markers in the emergency department we are measuring them as soon as possible after injury. We then compare them to the later traditional clinical diagnosis of AKI. The ultimate goal is to develop a panel of biomarkers which will detect AKI in all cases very soon after injury and so will allow early treatment and the saving of lives.
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Trial website
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Trial related presentations / publications
Endre ZH, Walker RJ, Pickering JW, Shaw GM, Frampton CM, Henderson SJ, Hutchison R, Mehrtens J, Robinson JM, Schollum JBW, Westhuyzen J, Celi LA, McGinley R, Campbell IJ, George PM (2010) Early intervention with erythropoietin does not affect the outcome of acute kidney injury (the EARLYARF trial). Kidney Int 77:1020-1030 (doi: 10.1038/ki.2010.25) Pickering JW and Endre ZH. (2009) Secondary outcomes of Acute Kidney Injury (AKI) Curr Op Crit Care, 15:488-97 Endre, ZH and Pickering JW. (2010) Outcome definitions in non-dialysis intervention and prevention trials in Acute Kidney Injury (AKI), Nephrol Dial Transpl, 25:107-118 Pickering, J.W., Endre, Z.H. (2010) Back-calculating baseline creatinine with MDRD misclassifies Acute Kidney Injury in the intensive care unit Clin J Am Soc Nephrol 5:1165-73 (doi:10.2215/CJN.08531109) Nejat M., Pickering, J.W., Walker R.J., Endre, Z.H. (2010) Rapid detection of acute kidney injury by plasma cystatin C in the intensive care unit Nephrol Dial Transplant, 25:3283-3289 (doi:10.1093/ndt/gfq176) Nejat M., Pickering J.W., Walker R.J., Westhuyzen J., Shaw G.M., Frampton C.M., Endre Z.H. (2010) Urinary cystatin C is diagnostic of acute kidney injury and sepsis, and predicts mortality in the intensive care unit. Critical Care, 14, R85, (doi:10.1186/cc9014) Pickering JW and Endre ZH. (2009) RIFLE and AKIN –maintain the momentum and the GFR! (letter), Crit Care, 13:416 Pickering JW, Frampton, C, Endre ZH. (2009) Evaluation of Trial Outcomes in Acute Kidney Injury by Creatinine Modelling, Clin J Am Soc Nephrol, 4:1705-1715 Pickering JW and Endre ZH. (2009) GFR shot by RIFLE: errors in staging acute kidney injury. The Lancet, 373: p. 1318-19 Westhuyzen J, Endre ZH, Reece G, Reith DM, Saltissi D, Morgan TJ. Measurement of tubular enzymuria facilitates early detection of acute renal impairment in the intensive care unit. Nephrol Dial Transplant (2003) vol. 18 pp. 543-551
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Zoltan Endre
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Address
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Christchurch Kidney Research Group
Department of Medicine
University of Otago Christchurch
PO Box 4345
CHRISTCHURCH 8140
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Country
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New Zealand
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Phone
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+64 3 364 1847
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Zoltan Endre
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Address
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Christchurch Kidney Research Group
Department of Medicine
University of Otago Christchurch
PO Box 4345
CHRISTCHURCH 8140
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Country
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New Zealand
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Phone
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+64 3 364 1847
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
The clinical utility window for acute kidney injury biomarkers in the critically ill.
2014
https://dx.doi.org/10.1186/s13054-014-0601-2
N.B. These documents automatically identified may not have been verified by the study sponsor.
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