AIMS
This study will examine serious kidney-related outcomes during the 180 days after a patient is admitted to an intensive care unit (ICU) with acute respiratory distress syndrome (ARDS), a severe condition in which the lungs cannot provide the body with enough oxygen. It will include people whose ARDS was related to COVID-19 and people whose ARDS had other causes. The researchers will also look for factors that may help predict which patients are most at risk.
BACKGROUND
Acute kidney injury (AKI) is a sudden reduction in kidney function. It is common among hospital patients who become seriously unwell with ARDS, including people with COVID-19. Previous studies suggest that the frequency of AKI may differ between COVID-19-related ARDS and ARDS caused by other illnesses, such as sepsis.
Researchers often assess longer-term kidney health using a combined measure called major adverse kidney events (MAKE). A MAKE outcome means that a person has experienced a substantial loss of kidney function, needs ongoing kidney support such as dialysis, or has died. There has been limited research comparing these outcomes after COVID-19-related ARDS and ARDS from other causes. A better understanding of who is most at risk could help guide future research into follow-up, tests and treatments to support recovery.
RESEARCH
The researchers will use routinely collected health information from University Hospitals Birmingham (UHB) through PIONEER. This will include information recorded when patients first received care, other health conditions, clinical observations, blood test results and subsequent outcomes. They will examine how often MAKE outcomes occur within 180 days and whether information available during the ICU admission is linked to a greater risk of these outcomes. The findings may help researchers design future approaches to identify and support patients at higher risk; this study itself will not test a new treatment.
PATIENT INVOLVEMENT
The study was discussed with established patient groups, including the NIHR Surgical Reconstruction and Microbiology Research Centre trauma patient group at Queen Elizabeth Hospital Birmingham and the Clinical Research Ambassador Group at Heartlands Hospital. These discussions took place alongside an earlier, related study about improving tools used to predict risk. That earlier study was reviewed and approved through the PIONEER data request process.
APPROVAL
The PIONEER Data Trust Committee unanimously supported this project.
The study is led by Dr Dhruv Parekh, Consultant in Critical Care at University Hospitals Birmingham and the University of Birmingham.
