Feasibility Assessment of a Biomarker-Guided Kidney-Sparing Sepsis Bundle: The Limiting Acute Kidney Injury Progression In Sepsis Trial.
acute kidney injury
biomarker
cell cycle arrest
sepsis
Journal
Critical care explorations
ISSN: 2639-8028
Titre abrégé: Crit Care Explor
Pays: United States
ID NLM: 101746347
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
medline:
24
8
2023
pubmed:
24
8
2023
entrez:
24
8
2023
Statut:
epublish
Résumé
To determine the feasibility, safety, and efficacy of a biomarker-guided implementation of a kidney-sparing sepsis bundle (KSSB) of care in comparison with standard of care (SOC) on clinical outcomes in patients with sepsis. Adaptive, multicenter, randomized clinical trial. Five University Hospitals in Europe and North America. Adult patients, admitted to the ICU with an indwelling urinary catheter and diagnosis of sepsis or septic shock, without acute kidney injury (acute kidney injury) stage 2 or 3 or chronic kidney disease. A three-level KSSB based on Kidney Disease: Improving Global Outcomes (KDIGOs) recommendations guided by serial measurements of urinary tissue inhibitor of metalloproteinases-2 and insulin-like growth factor-binding protein 7 used as a combined biomarker [TIMP2]•[IGFBP7]. The trial was stopped for low enrollment related to the COVID-19 pandemic. Nineteen patients enrolled in five sites over 12 months were randomized to the SOC ( Although the COVID-19 pandemic impeded recruitment, the actual implementation of a therapeutic strategy that deploys a KDIGO-based KSSB of care guided by risk stratification using urinary [TIMP2]•[IGFBP7] seems feasible and appears to be safe in patients with sepsis.
Identifiants
pubmed: 37614799
doi: 10.1097/CCE.0000000000000961
pmc: PMC10443738
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e0961Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.
Déclaration de conflit d'intérêts
The authors have disclosed that they do not have any potential conflicts of interest.
Références
Crit Care Med. 2021 Oct 1;49(10):1706-1716
pubmed: 33927121
Crit Care. 2013 Feb 06;17(1):R25
pubmed: 23388612
Anesth Analg. 2021 Aug 1;133(2):292-302
pubmed: 33684086
Adv Chronic Kidney Dis. 2016 May;23(3):179-85
pubmed: 27113694
Kidney Int. 2008 Oct;74(7):901-9
pubmed: 18596724
Curr Infect Dis Rep. 2007 Sep;9(5):382-6
pubmed: 17880848
Am J Respir Crit Care Med. 2016 Feb 1;193(3):281-7
pubmed: 26398704
PLoS One. 2018 Jun 5;13(6):e0198269
pubmed: 29870535
Lancet. 2020 Jan 18;395(10219):200-211
pubmed: 31954465
N Engl J Med. 2012 Jul 12;367(2):124-34
pubmed: 22738085
Biomark Med. 2014;8(10):1239-45
pubmed: 25525984
PLoS One. 2015 Mar 23;10(3):e0120863
pubmed: 25798585
Intensive Care Med. 2022 Feb;48(2):242-245
pubmed: 34921624
Am J Respir Crit Care Med. 2014 Apr 15;189(8):932-9
pubmed: 24559465
Chest. 2020 Oct;158(4):1431-1445
pubmed: 32353418
JAMA. 2016 Feb 23;315(8):801-10
pubmed: 26903338
Intensive Care Med. 2017 Nov;43(11):1551-1561
pubmed: 28110412
Nat Rev Nephrol. 2016 Jan;12(1):48-60
pubmed: 26434402
Crit Care. 2023 Feb 7;27(1):50
pubmed: 36750878
Anesth Analg. 2023 May 09;:
pubmed: 37159419
Kidney Int. 2011 Sep;80(6):633-44
pubmed: 21734638
Nephrol Dial Transplant. 2014 Nov;29(11):2054-61
pubmed: 25237065
Am J Respir Crit Care Med. 2017 Mar 15;195(6):784-791
pubmed: 27635668