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Trial registered on ANZCTR
Registration number
ACTRN12612000596808
Ethics application status
Approved
Date submitted
1/06/2012
Date registered
1/06/2012
Date last updated
2/07/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
To investigate whether the use of blood marker (plasma neutrophil gelatinase-associated lipocalin) can predict the development of subsequent kidney dysfunction in post non-heart surgical patients who are admitted to the intensive care unit
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Scientific title
Does plasma neutrophil gelatinase-associated lipocalin predict acute kidney injury in post non-cardiac surgery-patients that require ICU care?
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Secondary ID [1]
280597
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None
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Universal Trial Number (UTN)
None
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Trial acronym
None
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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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Post non-cardiac operation
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Condition category
Condition code
Renal and Urogenital
286877
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0
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Kidney disease
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Surgery
286878
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0
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Other surgery
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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
The major objective of the study was to estimate the diagnostic accuracy of plasma NGAL on predicting subsequent development of acute kidney injury in non-cardiac postoperative patients that required intensive care. Plasma NGAL was taken within 1 hour and at 6th hour of post-operative ICU admission. Patients are observed until discharge from ICU to assess the presence of any acute kidney injury, requirement of renal support, ICU mortality
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Intervention code [1]
284989
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Not applicable
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Comparator / control treatment
Nil
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Occurrence of Acute kidney injury, defined based on Risk, Injury, Failure, Loss and End stage (RIFLE) classification
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Assessment method [1]
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Timepoint [1]
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48 hours from ICU admission
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Secondary outcome [1]
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Requirement of renal replacement therapy (needs of hemofiltration/ hemodiafiltration/ hemodialysis/ continuous renal replacement therapy, based on medical records upon ICU discharge)
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Assessment method [1]
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Timepoint [1]
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During ICU stay
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Secondary outcome [2]
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ICU length of stay (based on medical records upon ICU discharge)
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Assessment method [2]
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Timepoint [2]
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Upon ICU discharge
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Secondary outcome [3]
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ICU mortality (based on medical records upon ICU discharge)
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Assessment method [3]
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Timepoint [3]
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Upon ICU discharge
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Eligibility
Key inclusion criteria
1. All emergency and elective post non-cardiac operation patients that required ICU care
2. Expected ICU length of stay >24 hours
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Minimum age
18
Years
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Maximum age
85
Years
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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. Patients with chronic kidney disease stage 5 (Glomerular filtration rate estimated by Modification of Diet in Renal Disease (MDRD) equation of less than 15 ml/min) or those on renal replacement therapy
2. Surgical intervention that included nephrectomy
3. Cannot obtain consent from patients or their relatives
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/07/2012
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Actual
1/12/2012
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Date of last participant enrolment
Anticipated
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Actual
28/02/2014
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Date of last data collection
Anticipated
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Actual
30/06/2014
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Sample size
Target
155
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Accrual to date
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Final
151
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Recruitment outside Australia
Country [1]
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Hong Kong
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State/province [1]
4342
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Pamela Youde Nethersole Eastern Hospital
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Address [1]
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3 Lok Man Road, Chai Wan
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Country [1]
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Hong Kong
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Primary sponsor type
Individual
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Name
Shum Hoi Ping
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Address
Department of intensive care
Pamela Youde Nethersole Eastern Hospital
3 Lok Man Road, Chai Wan
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Country
Hong Kong
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Secondary sponsor category [1]
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Commercial sector/Industry
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Name [1]
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SCIENCE INTERNATIONAL CORPORATION
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Address [1]
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14/F, Gee Tuck Building, 16-20 Bonham Strand East, Sheung Wan
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Country [1]
284206
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Hong Kong
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Hong Kong East Cluster Ethics Committee
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Ethics committee address [1]
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Pamela Youde Nethersole Eastern Hospital 3 Lok Man Road, Chai Wan
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Ethics committee country [1]
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Hong Kong
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Date submitted for ethics approval [1]
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Approval date [1]
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21/05/2012
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Ethics approval number [1]
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HKEC-2011-091
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Summary
Brief summary
In surgical patients, outcome is strictly dependent on the occurrence of postoperative complication. Acute kidney injury (AKI) occurs in around 1% of noncardiac surgical patients and is commonly associated with more serious complications and poorer outcome (1). Serum creatinine is an insensitive marker for acute kidney injury and may not peak until several days after tubular insult (2). Neutrophil gelatinase-associated lipocalin (NGAL) is expressed by neutrophils, various epithelia as well as in the renal tubules (3). It is highly expressed in cells after infections, inflammation, ischemia or neoplastic transformation. Recent studies suggest that measurement of NGAL in patients at risk for cardiac surgery associated AKI can facilitate early diagnosis and implementation of therapeutic adjustment that decrease renal insult (4). However, the data on applications of plasma NGAL on predicting AKI in non-cardiac surgical patients is limited (5). The major objective of the study was to estimate the diagnostic accuracy of plasma NGAL on predicting subsequent development of AKI in non-cardiac postoperative patients that required intensive care. Additional objectives were to evaluate plasma NGAL as a biomarker for renal replacement therapy (RRT) use, intensive care unit (ICU) mortality and ICU length of stay. Workflow: 1. Eligible patients should fulfill all the inclusion criteria and without any exclusion criteria 2. Obtain consent from patient directly. For those with impaired consciousness due to underlying illness or use of sedatives, consent should be obtained from their close relatives. Clear explanation of the workflow should be performed with the use of the information sheet. 3. Plasma NGAL was taken within 1 hour and at 6th hour of post-operative ICU admission. 4. Blood samples were processed within 1 hour of collection using point of care test. 5. Primary and secondary outcomes were analysed subsequently based on medical records Reference: 1. Brienza N, Giglio MT, Marucci M. Preventing acute kidney injury after noncardiac surgery. Curr Opin Crit Care. 2010;16:353-358. 2. Bellomo R, Kellum JA, Ronco C. Defining acute renal failure: physiological principles. Intensive Care Med. 2004;30:33-37. 3. Kjeldsen L, Cowland JB, Borregaard N. Human neutrophil gelatinase-associated lipocalin and homologous proteins in rat and mouse. Biochim Biophys Acta. 2000;1482:272-283. 4. Cruz DN, Ronco C, Katz N. Neutrophil gelatinase-associated lipocalin: a promising biomarker for detecting cardiac surgery-associated acute kidney injury. J Thorac Cardiovasc Surg. 2010;139:1101-1106. 5. Shavit L, Dolgoker I, Ivgi H, Assous M, Slotki I. Neutrophil gelatinase-associated lipocalin as a predictor of complications and mortality in patients undergoing non-cardiac major surgery. Kidney Blood Press Res. 2011;34:116-124.
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Trial website
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Trial related presentations / publications
HP Shum et al.: Nephrology 20 (2015) 375–382
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Public notes
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Contacts
Principal investigator
Name
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Dr Dr Shum Hoi Ping
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Address
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Department of Intensive Care
Pamela Youde Nethersole Eastern Hospital
3 Lok Man Road, Chai Wan
Hong Kong SAR
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Country
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Hong Kong
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Phone
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+852-25956111
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Shum Hoi Ping
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Address
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Department of Intensive Care
Pamela Youde Nethersole Eastern Hospital
3 Lok Man Road
Chai Wan
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Country
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Hong Kong
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Phone
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+852-25956111
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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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Dr Shum Hoi Ping
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Address
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Department of Intensive Care
Pamela Youde Nethersole Eastern Hospital
3 Lok Man Road
Chai Wan
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Country
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Hong Kong
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Phone
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+852-25956111
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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
Predictive value of plasma neutrophil gelatinase-associated lipocalin for acute kidney injury in intensive care unit patients after major non-cardiac surgery.
2015
https://dx.doi.org/10.1111/nep.12400
N.B. These documents automatically identified may not have been verified by the study sponsor.
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